LIBRARY 

OF  Tin: 


UNIVERSITY  OF  CALIFORNIA. 


Deceived 

No  . 


,  189 


0  o  fl » 0  o  f) » o  •  fl  <•  Q  *>  MMi • 0  eOy 


TRANSITORY  MANIA 


MEDICO-LEGAL   BEARING 


A  PRIZE  ESSAY 

Read  before  the  Medical  Society  of  the  State  of  California, 
April  i^th,  1885 


BY 
WASHINGTON  AYER,    MD.       ' 

Member  of  the  "Harvard  Club;'"    Ex-President  of  the  Medical  Society  of  the 

State  of  California  ;    Ex-President  of  the  Medical  Society  of  the  City 

and  County  of  San  Francisco;   and  Ex-President  of  the 

San  Francisco  Medical  Benevolent  Society 


SAN  FRANCISCO: 

li'.  S.  Duncombe,  Publisher 
30  Post  Street 


DEDICATION. 


TO  THE  HON.  (P- 
JUDGE  OF  THE  SUPERIOR  COURT, 
CRIMINAL  DEPARTMENT  OF  SAN  FRANCISCO, 

THE  FOLLOWING  PAGES 

ARE  RESPECTFULLY  DEDICATED 

BY  THE  AUTHOR. 


OF 

7BRSIT7 


PREFACE. 


In  preparing  this  "essay"  I  have  endeavored  to  show,  by 
introducing  various  subjects  connected  with  physics,  that  all 
mental  alienations  are  dependent  upon  changes  and  develop- 
ments of  the  brain,  and  not  upon  the  mind  itself  as  an  essence 
emanating  from  the  crucible  of  Omnipotent  Will,  to  be  measured 
and  weighed  as  the  weird  offspring  of  unrelenting  fate. 

While  not  intending  to  criticise  law  as  a  science,  the  medico- 
legal  bearing  of  the  subject  has  led  me  to  give  such  interpreta- 
tion to  special  law,  and  criticise  its  application  to  specific  cases, 
as  would  enable  me  in  the  most  forcible  manner  to  present 
reasons  for  the  labor  and  burden  of  proof  against  the  theory 
of  mania  transitoria  I  have  undertaken. 

Feeling  that  public  sentiment  has  too  often  and  too  long  been 
outraged  by  the  admission  of  this  theory  into  the  pleadings  for 
the  benefit  and  protection  of  those  who  have  most  wantonly 
committed  homicides,  I  have  devoted  my  time  to  the  investiga- 
tion of  the  subject,  with  no  motive  beyond  a  wish  to  serve  the 
interests  of  the  public  by  endeavoring  to  make  the  murderer 
responsible  for  his  crime,  and  to  show  that  if  legal  penalties  are 
not  inflicted  upon  the  guilty,  all  virtue  and  morality  will  soon  be 


trodden  under  foot,  and  communism  or  anarchy  will  put  at  de- 
fiance the  majesty  of  law. 

I  have  cited  several  noted  cases  that  have  come  into  our  courts, 
for  the  purpose  of  showing  the  importance  of  instituting  a  thorough 
investigation  of  this  subject ;  and  have  referred  to  many  facts  con- 
nected with  the  changes  that  take  place  in  the  brain  to  prove  that 
the  mind  is  not  of  itself  diseased,  and  cannot  possibly  become 
diseased;  for  the  human  mind  is  the  individualized  offspring  of 
the  Creative  Mind,  which  gave  birth  to  worlds  and  brought 
order  out  of  chaos,  and  must  forever  remain  unchanged.  What- 
ever is  subject  to  disease  is  also  subject  to  decay  and  death ;  but 
the  mind  is  a  part  of  the  Immortal  Essence,  which  survives  de- 
cay and  will  never  die. 


ESSAY  AND 

UPON 


TRANSITORY     MANIA 


WITH    ITS 


BEARING. 


Mr.  President,  and  Fellows  of  the  Medical  Society  of  the  State  of 
California : 

1 '  The  labor  of  life  is  a  constant  struggle  between  the  acts  of 
conscious  volition  and  the  automatic  impulses  of  the  emotional 
regions  of  our  being, ' '  and  as  we  are  borne  along  upon  the  hur- 
rying breath  of  time,  how  much  we  see  to  do,  and  yet  how  little 
we  accomplish  \  While  we  pursue  the  study  of  the  brain  and 
search  for  the  seat  of  mental  activity,  the  shadows  of  ignorance 
and  doubt  give  way  to  the  fulfillment  of  prophetic  knowledge, 
whose  stream  leads  on  to  the  " ocean  of  truth"  and  "ineffable 
light."  We  live  in  an  age  of  investigation,  an  age  in  which 
declaration,  unsupported  by  demonstrative  knowledge,  is  of  no 
value,  and  it  is  the  right  of  every  man  to  differ  from  his  neigh- 
bor. 

And  now,  in  a  spirit  which  cherishes  love  for  justice,  reverence 
for  law,  and  sympathy  for  the  unfortunate,  I  invite  your  attention 
to  the  subject  of  Mania  Transitoria,  with  its  medico-legal  bearing. 


8 

Fully  conscious  of  the  many  difficulties  surrounding  the  intelli- 
gent discussion  of  this  question,  I  shall  not  confine  myself  strictly 
to  a  synthetic  line  of  argument,  but  shall  call  attention  to  such 
subjects  as  occur  to  me  to  be  of  importance  to  the  profession  in 
this  connection ;  such  as  expert  testimony,  questions  of  law  and 
rulings  of  courts  upon  questions  of  irresistible  impulse,  emotional 
insanity,  and  moral  obligations  to  society,  as  the  subject  is  of 
special  legal  importance,  and  involves  many  of  the  perplexities 
of  jury  trials.  I  shall  also  present  such  reflections  as  naturally 
arise  as  the  outgrowth  of  my  argument,  without  claiming  for 
them  original  scientific  conclusions,  hoping  to  awaken  some  new 
thoughts  in  the  mind  of  the  careful  student  upon  this  subject. 

With  the  results  of  the  investigations  of  Brown- Sequard  to 
guide  us  in  our  inquiries,  as  well  as  many  other  authors  who 
have  written  upon  the  subject  of  nervous  and  mental  diseases, 
and  the  researches  of  Luys  upon  the  "  Functions  of  the  Brain," 
aided  as  they  have  been  by  experiments  in  vivisections,  there  can 
be  no  doubt  of  the  localization  of  nervous  disease  and  mentality 
within  the  cerebral  hemispheres  and  medulla  oblongata  ;  and  the 
correctness  of  the  theory  of  the  proliferation  of  brain  cells,  and 
that  they  are  the  seat  of  mental  activity  and  repositories  of  mem- 
ory and  knowledge,  can  hardly  be  doubted.  With  this  view  oi 
the  subject,  and  our  knowledge  of  the  functions  of  the  brain  in 
their  control  of  all  physical  functions,  we  are  led  to  conclude  that 
the  advantage  one  has  over  another  in  scholarly  acquirements 
lies  in  his  greater  receptivity  as  the  result  of  achievements  in 
scholastic  learning. 

It  is  frequently  asked  how  it  occurs  that  one  in  advanced  years 
remembers  the  things  of  childhood  with  more  freshness  than  the 
things  of  yesterday.  This  can  be  explained  upon  the  theory  ol 
the  proliferation  of  brain  cells  as  the  seat  of  mental  activity.  To 
make  the  explanation  simple,  we  will  assume  that  the  cells  are 


never  separated,  but  remain  intact,  and  form  a  pyramid  or  cone, 
the  base  representing  youth,  and  the  apex,  age.  Now,  as  light 
falls  upon  the  eye  to  produce  an  image  upon  the  retina,  or  sound 
comes  to  the  ear,  the  optic  and  auditory  nerves  vibrate  and  put 
these  spiral  columns  in  motion,  and  the  greatest  displacement 
will  be  at  the  base,  the  largest  axis  of  spherical  action,  and  the 
point  where  the  first  impressions  of  lisping  childhood  are  made ; 
each  lobe  and  convolution  of  the  brain,  with  its  millions  of  cells, 
being  assigned  for  special  memories ;  and  where  the  vibration  is 
greatest  the  memory  will,  be  aroused  first  and  strongest,  while 
the  effect  upon  the  apex  will  be  scarcely  disturbed  and  soonest 
obliterated.  Hence,  the  memory  of  childhood  impressions  are 
soonest  brought  before  us  in  age. 

As  we  are  dealing  with  physical  functions  which  control  and 
enable  us  to  classify  mental  activities,  the  discussion  of  mental 
disturbances  justifies  the  introduction  of  this  theory  of  thought 
impressions  upon  proliferated  brain-cells  as  a  basis  of  further  in- 
vestigation, and  a  means  of  obtaining  experimental  knowledge 
of  the  psychic  laws  which  make  man  a  responsible  being. 

Until  within  the  past  few  years,  brain-cells  were  considered 
only  a  "  shapeless  mass  of  protoplasm  ;"  but  now  they  are  known 
to  be  delicately  constructed,  and  possibly  contain  the  realistic 
germs  of  life-forces  which  survive  physical  decay. 

In  this  connection,  as  a  matter  of  speculation,  we  may  be  justi- 
fied in  saying  that  within  these  microscopic  cells,  thought  im- 
pressions are  made,  and  there  remain  till  interrupted  by  disease 
and  decay,  as  impressions  of  objects  are  made  upon  the  glass 
or  other  polished  surfaces  within  the  camera,  to  be  again  trans- 
ferred ;  or  as  sound  is  collected  to  be  reproduced  by  the  phono- 
graph at  the  will  of  the  operator ;  and  it  seems  to  me  possible 
that  men  may  yet  learn  that  the  elastic  atmosphere  is  forever 
vibrating  with  vocal  strains  as  an  evidence  of  the  realisms  await- 


IO 

ing-  the  intellectual  enjoyments  of  etherealized  matter,  called 
mind.  • 

In  the  reverberation  of  the  clouds,  in  the  tumult  of  the  air,  in 
the  commotion  of  waves,  in  the  summer  calm,  and  wherever  we 
turn,  we  find  the  expression  of  a  living  thought,  begetting  inspi- 
ration and  urging  man  to  investigate  the  causes  of  the  wonders 
he  beholds,  and  appropriate  his  knowledge  to  advance  his  hap- 
piness and  comfort,  and  no  obstacle  seems  too  great  to  be  over- 
come. 

In  the  study  of  the  mind  and  the  effects  of  physical  disturb- 
ances upon  mental  activity,  we  seem  treading  in  the  path  of  the 
"  unknowable,"  and  grow  bewildered  as  we  cautiously  attempt 
to  lift  the  veil  that  conceals  all,  to  gain  a  glimpse  of  primeval 
causes.  Though  we  cannot  paint  the  dying  refrain  of  summer 
upon  the  canvas  with  the  woods  and  fields,  resonant  with  song 
and  redolent  with  the  perfume  of  flowers,  it  will  continue  to 
live  in  the  unknown  recess  of  mind,  to  be  reproduced  again 
and  again,  and  add  to  the  pleasures  of  the  future  through  the 
memory  of  the  past.  But  there  yet  remains  much  we  can  learn 
in  the  vast  fields  of  discovery,  *and  can  accomplish  and  know, 
what  is  now  unknown  and  full  of  seeming  mystery,  awaiting  the 
voice  of  science  to  be  declared  to  man  while  he  struggles  amid 
the  unmeasured  forces  of  life  in  search  of  new  truths,  amazed 
in  the  contemplation  of  the  wonderful  works  of  a  Creative  In- 
telligence. 

But  we  cannot  think  and  speak  much  in  advance  of  the  times 
in  which  we  live  without  some  accusation  of  heresy  being  hurled 
at  th(pse  who  dare  oppose  the  teachings  of  the  present  age, 
whether  such  teachings  be  in  the  line  of  legitimate  medicine 
or  opposed  to  popular  theology,  or  the  ethics  and  precepts  of 
law  ;  yet  an  honest  effort  cannot  be  without  its  ultimate  merited 
reward. 


II 

The  mincl  grows  weary  and  unsteady  in  its  volitional  manifest 
ations  in  abeyance  to  the  laws  of  physical  inertia,  as  a  general 
proposition — exceptions  to  be  noted — and  the  conscious  volition 
then  fails  to  direct  the  eliminating  forces  of  intellectuality  in  the 
pathway  of  mental  activity  and  reason,  being  governed  by  the 
same  laws  which  apply  to  the  disordered  functions  of  physical 
life,  dependent  upon  lesions  of  the  brain  and  spinal  cord,  or  me- 
dulla oblongata,  as  witnessed  in  myelitis  and  the  various  forms 
of  paralysis  ;  and  whenever  the  pans  varolli,  crus  cerebri,  corpora 
striata,  or  any  of  the  nerve  centres  are  over-stimulated  or  pressed 
upon,  we  shall  invariably  witness  either  a  loss -of  motion  and  sen- 
sation, and  loss  of  will  power  upon  the  parts  affected  at  the  same 
time,  or  an  error  of  judgment ;  and  no  one  can  reasonably  doubt 
the  intimate  and  inseparable  relations  of  will  and  motion  as  a 
physiological  proposition  in  all  healthy  bodies,  except  such  mo- 
tions as  are  or  may  be  governed  by  their  own-  specific  ganglia, 
and  those  which  are  from  their  nature  involuntary,  as  pulsation 
of  the  heart,  nictation,  respiration,  paristole,  etc. 

In  all  the  civil  and  social  relations  of  life,  where  there  is  wit- 
nessed refined  tastes  and  polished  manners,  we  must  acknowledge 
the  importance  of  a  clear  mental  capacity  to  appreciate  in  the 
selection  of  companionship.  No  question  connected  with  medi- 
cal science  more  deeply  concerns  the  best  interests  of  society 
and  social  life  than  that  which  is  known  as  "  mental  disease ;"  yet 
how  little  is  known  by  a  majority  of  medical  gentlemen  upon  so 
important  a  subject. 

The  literature  upon  this  special  department  of  scientific  knowl- 
edge seems  to  be  ample  as  a  basis  of  investigation,  to  enable  the 
analytical  mind  to  make  such  delicate  and  clear  distinction  be- 
tween mens  sana,  aut  non,  that,  when  we  are  called  into  criminal 
courts  as  experts,  the  learned  members  of  the  bar  and  the  judges 
upon  the  bench  may  be  answered  intelligently  and  with  credit  to 
the  profession  we  represent. 


12 

Works  upon  medical  jurisprudence  only  partially  treat  upon 
this  subject,  presenting  it  in  its  medico-legal  bearing,  and  leave 
the  important  functions  of  the  brain  and  effects  of  molecular  per- 
turbation on  mental  forces  to  be  investigated  in  another  depart- 
ment of  learning;  and  intelligent  juries  now  look  to  the  physi- 
cian to  aid  them  in  determining  the  difference  between  an  invol- 
untary and  unconscious  action  and  a  voluntary  act.  As  a  simple 
illustration,  winking  may  be  an  involuntary  action,  while  closing 
the  eyes  to  slumber  is  a  voluntary  act.  Walking,  talking,  and 
singing  while  asleep  are  unconscious  voluntary  acts,  while  the  same 
exercises  when  awake  constitute  conscious  voluntary  acts ;  for  in 
a  healthy  body  the  suspension  of  volition  would  be  followed  by  a 
suspension  of  motion,  as  witnessed  in  paralysis.  This  is  axiom- 
atic. 

J.  H.  Belfour  Browne  is  generally  considered  authority  upon 
forensic  medicine,  but  a  careful  analysis  of  some  of  his  statements 
will  show  he  is  not  always  correct.  He  says  :  "  Dementia  is  an 
exaggerated  enfeeblement  of  age,  a  more  ruinous  dotage.  It  is 
dependent  upon  exhaustion  and  torpor  of  the  mind,  that  the 
mental  house  is  in  ruins,  etc." — Page  276.  This,  however,  is  not 
correct,  for  dementia  is  the  enfeeblement  of  the  forces  of  mental 
activity,  dependent  upon  cerebral  disturbances  of  various  kinds. 
Again  he  says:  "Dementia  is  the  inertia  of  rest — mania  the 
inertia  of  motion." — Page  279.  Now  there  is  nothing  in  medi- 
cine nor  in  physics  to  support  these  statements,  and  give  them 
any  importance  in  a  court  of  justice. 

As  intelligent  testimony  is  the  motor  power  applied  to  the 
machinery  of  law,  which  weaves  facts  into  every  conceivable 
fabric,  and  coloring  to  be  presented  for  judicial  inspection,  and 
to  juries  to  enable  them  to  return  just  verdicts,  if  the  physician 
would  become  a  valuable  witness,  and  assist  criminal  courts  in  the 
administration  of  wholesome  laws,  he  should  make  himself  famil- 


13 

iar  with  the  medico-legal  bearing  of  mental  disease  upon  crimi- 
nal acts,  before  going  upon  the  witness  stand  to  give  his  testi- 
mony. 

For  the  benefit  of  the  younger  members  of  the  profession,  I 
would  say,  we  must  always  be  on  the  qui  vive  while  in  court,  as 
hypothetical  questions  are  often  asked,,  interwoven  with  paradox- 
ical theories  to  test  the  competency  of  a  witness,  rather  than  to 
elicit  any  material  facts  connected  with  the  subject  of  insanity. 

To  obviate  the  embarrassment  that  naturally  follows  upon  an 
evasive  or  confused  answer,  a  common  estimate  of  the  value  of 
symptoms  should  be  formulated  and  agreed  upon,  as  the  result 
of  experience,  observation  and  careful  investigation. 

At  the  present  day  a  large  number  of  the  intelligent  people  of 
our  country  are  inclined  to  look  with  disfavor  upon  all  medical 
expert  testimony  before  juries,  and  a  majority  seem  to  regard 
the  proceedings  of  our  criminal  courts,  in  many  cases,  as  farcical 
dramas  brought  upon  the  judicial  stage,  before  the  bar  of  justice 
in  opposition  to  the  spirit  of  the  higher  codes  of  law,  which  in- 
flicts punishment  upon  the  guilty ;  and  justice  stands  behind  the 
proscenium  taking  no  part  in  the  proceedings,  and  leaving  the 
criminal  with  his  weakness  and  errors  to  the  sympathy  of  juries, 
often  composed  of  men  incompetent  to  tell  the  difference  between 
a  hypothetical  question  and  an  axiom  of  law.  This  is  especially 
the  case  when  the  criminal  is  being  tried  for  homicide,  and  the 
defense  puts  in  the  plea  of  irresponsibility,  on  the  ground  of 
transitory  or  emotional  insanity.  Who  is  responsible  for  the 
failure  to  convict  in  such  cases  but  the  medical  expert,  and  those 
who  mis-apply  and  mis-interpret  facts?  There  are  but  few  emi- 
nent writers  upon  this  subject  who  give  unqualified  endorsement 
to  the  theory  of  transitory  mania,  yet  the  sophistry  of  learned 
attorneys  and  the  testimony  of  pliant  medical  witnesses,  carry 
conviction  to  the  minds  of  jurors  that  the  murderer  is  not  re- 
sponsible under  such  alleged  conditions  for  his  act. 


This  was  illustrated  in  the  suit  of  the  People  vs.  Laura  D.  Fair, 
one  of  the  most  noted  cases  that  appear  upon  the  records  of  our 
criminal  courts  of  the  State  of  California,  where  the  plea  for  the 
defendant  was  transitory  or  emotional  insanity,  "and  the  act  was 
non-volitional."  In  this  case  the  effect  upon  the  jury  of  the  tes- 
timony of  the  physicians  who  were  called  as  experts  on  the  first 
trial,  was  not  such  as  to  receive  any  favorable  comment,  as  it  did 
not  appear  to  be  wholly  in  accordance  with  the  facts  sought  to 
be  presented;  nor  was  it  free  from  the  appearance  of  bias,  a  con- 
dition of  mind  most  unfortunate  for  a  witness  in  a  court  of  justice. 
On  the  second  trial  the  effect  of  expert  testimony  on  the  part  of 
the  physicians  was  such  that  it  could  not  be  overcome  by  the 
eloquence  of  polished  rhetoric,  finished  oratory,  and  scholarly 
argument,  and  the  prisoner  was  acquitted. 

MURDER  OF  CHAS.  DE  YOUNG. 

Nothing  could  be  more  injurious  to  church  ethics,  or  more  in- 
sulting to  Christian  precepts,  and  more  demoralizing  to  the  youth 
of  a  populous  city,  than  the  example  presented  by  the  killing  ot 
Mr.  Chas.  De  Young,  by  Kalloch,  a  minister  of  the  gospel. 

In  this  case  we  find  the  law  was  made  a  creature  of  sym- 
pathy by  a  maudlin  sentiment  that  echoed  from  the  bells  upon 
the  church  towers  along  the  corridors  and  through  the  aisles  of 
the  temples  of  worship,  until  it  reached  the  ears  of  the  jury  and 
deprived  justice  of  its  executive  authority;  and  a  greater  outrage 
upon  offended  law  can  scarcely  be  conceived  than  was  witnessed 
in  the  result  of  this  trial.  Here  the  expert  testimony  was  much 
more  declamatory  than  logical,  and  was  in  no  wise  entitled  to  the 
position  it  occupied  in  the  category  of  evidence  for  the  defendant. 

The  great  effort  of  prominent  members  of  the  bar  appears  to 
be  to  protect  the  criminal  against  the  law,  rather  than  secure  the 
enforcement  of  its  penalties,  and  this  is  the  /we  opus  which  tends 


15 

to  make  crime  rampant  and  subvert  good  government.  Expe- 
rience and  daily  observation  teach  us  that  it  needs  no  forensic 
oratory,  no  long  recitations  from  Shakespear,  no  quotations  from 
Milton's  Paradise  Lost,  no  quotations  from  Young's  Night 
Thoughts,  whose  windows  of  light  were  forever  darkened,  or 
from  Covvper,  to  inform  a  jury  that 

"  Unnumbered  throngs  on  every  side  are  seen, 
Of  bodies 'changed  by  various  forms  of  spleen," 

and  that  the  prisoner  charged  with  homicide  is  not  guilty,  pro- 
vided handy  witnesses  are  secured,  and  the  right  kind  of  men 
are  placed  in  the  jury-box. 

You  may  ask,  "  What  have  medical  gentlemen  to  do  with 
this  ?"  Let  me  assure  you  we  have  much  to  do  with  the  convic- 
tion of  the  guilty,  by  giving  testimony,  supported  by  the  facts 
presented  by  the  laws^of  physiology 'and  psychosis,  which  dig- 
nify and  control  human  action. 

The  study  of  nervous  diseases  and  mentality,  and  inquiries 
into  the  forces  governing  the  functions  of  the  brain,  by  those  who 
have  had  large  opportunities  for  experimenting  upon  the  lower 
animals  in  vivisections,  have  called  in  exercise  new  reflections, 
and  given  new  encouragement  to  the  investigation  of  mental  dis- 
eases. And  while  mind  cannot  be  examined,  only  by  logical  de- 
ductions, much  that  controls  its  functions  can  yet  be  learned,  as 
we  learn  the  nature  of  imponderable  agents,  by  their  effect  upon 
animate  and  inanimate  objects,  as  reason  lifts  the  veil  beneath 
which  volition  dwells,  and  discloses  the  working  of  the  forces 
that  direct  and  control  the  acts  of  men,  and  define  his  responsi- 
bility in  every  incFividual  act. 

It  is  a  maxim  in  common  law  that  "all  persons  are  presumed 
to  be  innocent  until  proven  guilty."  Judge  S.  H.  Dwinell,  in 
his  charge  to  the  jury  in  the  case  of  the  People  vs.  Laura  D.  Fair, 
says:  "All  the  presumptions  .of  law,  independoi^of  evidence, 


i6 

are  in  favor  of  innocence,  and  every  person  is  presumed  to  be 
innocent  of  crime  until  he  is  proven  to  be  guilty."  But  the  law 
really  does  no  such  thing  in  its  application ;  if  it  did,  it  would 
not  arm  its  officers  with  authority  to  arrest  and  hold  persons  in 
duress  until  such  time  as  they  may  be  brought  into  court  to  prove 
their  innocence.  Otherwise  the  rights  of  individuals  would  be 
taken  away,  without  any  possible  redress  at  law  for  inconvenience 
and  hardships  endured ;  for  no  person  can  justly  be  restrained 
of  his  liberty  unless  he  is  presumed  to  be  guilty  or  insane — ex- 
cept he  be  restrained  as  a  witness  in  the  interest  of  justice — and 
officers  making  arrests  would  be  liable  to  be  charged  with  being 
governed  by  an  improper  influence — malo  animo — in  the  dis- 
charge of  their  duties,  and  this  would  be  a  conspicuous  error. 

In  dealing  with  crime,  ''Justice  a  priori  ascribes  responsibility 
to  all  who  commit  it,"  and  consequently  must  look  with  suspi- 
cion upon  all  placed  under  arrest,  whether*sane  or  insane,  and  the 
condition  of  the  mind  in  its  capability  to  determine  right  from 
wrong  must  alone  decide  the  responsibility  in  any  individual 
case,  for  ignorance  of  law  is  no  excuse  for  wrong  doing.  Ignor- 
antia  legis  neminem  excusat. 

When  the  maxim  referred  to  is  the  ruling  of  the  court,  for  the 
purpose  of  arresting  a  popular  verdict  in  any  case  before  it  has 
been  tried,  it  is  well  enough  as  tending  to  prevent  meddlesome 
interference  with  the  proce'edings  of  the  trial.  But  we  have  no 
dealings  with  maxims  in  the  abstract  which  apply  to  the  guilt  or 
innocence  of  any  party  ;  and  all  the  court  and  jury  want  us  to  do 
is  to  make  a  clear  statement  of  facts  relating  to  mental  conditions, 
and  nothing  more  in  cases  of  alleged  insanity. 

We  must  not  only  have  ideas,  but  must  have  positive  facts 
upon  which  to  base  our  testimony. 

AN  IDEA. — An  idea  is  an  element  or  condition  of  mind  as  it  re- 
lates to  sanity  or  insanity,  and  develops  rapidly  into  various  ex- 


17 

pressions  of  language  and  acts,  which  may  be  rational  or  not, 
according  to  the  varying  circumstances  upon  which  it  is  depend- 
ent. 

IMPULSE. — Impulse  is  a  sudden  feeling  different  from  that  which 
is  controlling  the  action  of  the  individual  at  the  time  it  occurs ; 
and  while  it  is  not  voluntary,  and  cannot  be  brought  into  play 
by  any  force  of  the  mind,  it  is  subjective  to  the  will  when  mani- 
fested ;  and  this  is  in  accordance  with  the  experiences  of  daily  life. 
It  differs  from  an  impression  in  this  :  An  impression  is  the 
consciousness  of  the  existence  of  something,  while  an  impulse 
relates  to  an  action  or  desire  to  act. 

Impulse  is  not  the  product  of  thought  which  springs  from  or 
enters  into  the  domain  of  mind,  but  is  developed  by  some  ex- 
traneous or  concentric  action  of  the  vital  aura,  or  surrounding 
•erethism  of  the  body ;  while  many  of  the  moral  feelings  are  the 
offsprings  of  thought,  such  as  sorrow  or  joy,  and  sometimes 
thought- — very  emphatic — is  the  offspring  of  pain,  as  experienced 
in  gout  or  neuralgia,  and  this  paradoxical  condition  is  depend- 
ent upon  the  flex  and  reflex  nervous  action,  stimulating  certain 
•cerebral  nerve  centers.  But  "  impulse ' '  is  exhausted  the  moment 
it  is  felt,  and  gives  birth  to  reflection,  which  urges  one  on  to 
uncontrolled  action ;  but  never  irresistible  in  its  nature,  as  re- 
flection is  always  rational  in  character,  and  must  be  subjective 
to  the  will. 

Upon  this  is  based  all  of  the  theory  of  transitory  mania,  which 
is  only  a  convenient  myth — a  huge  joke  on  ethics  and  crim- 
inal law — merely  a  word-structure  of  defense  without  a  possible 
reality;  and  the  learned  members  of  the  bar  do  not  believe  in  its 
existence. 

A  more  ridiculous  burlesque  upon  justice  cannot  well  disgrace 
the  procedure  of  criminal  courts  than  is  witnessed  in  a  trial 
when  the  argument  for  the  defense  is  based  alone  upon  this 


i8 

theory;  for  it  is  not  within  the  reach  of  psychic  reasoning,  or  the 
logic  of  presumption,  and  is  little  more  than  nonsense,  imbeded 
in  metaphysics,  without  a  ray  of  intelligent  possibility  to  dignify 
an  argument  in  its  favor,  and  is  far  more  quixotic  than  the 
Rosicrucian  philosophy,  or  the  animisms  of  Stahl. 

This  theory  not  only  aims  to  encourage  crime,  and  relieve  the 
criminal  from  responsibility,  but  lessens  public  respect  for  the 
Temple  of  Justice. 

And  in  this  we  see  justice  struggling — 

"See  physic  beg  the  Stagyrites'  defense — 
See  metaphysics  call  for  aid  on  sense." 

With  this  view  of  the  subject,  I  am  conscious  of  invading  the 
domain  of  cherished  opinions  of  some  of  the  eminent  writers 
and  opposing  their  theories,  yet  I  do  so -not  in  a  spirit  of  hostility, 
but  with  a  desire  to  advance  justice  and  the  interests  of  the  pro- 
fession. 

Oh,  common  sense,  divinest  child  of  earth  ! 
May  reason's  choral  voice  thy  praise  prolong, 
.Till  nature,  wearied,  sinks  beneath  the  song. 

Judge  Hoffman's  opinion  of  emotional  sanity  and  transitory 
mania. — In  the  case  of  Mary  Jane  Sweeney,  the  defense  begged 
leniency  in  consideration  of  Sweeney's  emotional  insanity.  The 
Judge  replied:  "This  plea  of  emotional  insanity,  or  transitory 
mania,  or  whatever  name  the  excuse  may  be  given,  has  become 
almost  ridiculous."  "  Our  experience  in  California  in  respect  to 
this  subject  has  led  us  to  regard  the  present  aspect  which  the  in- 
sanity plea  has  assumed,  as  repulsive  to  justice  and  fatal  to 
society." 

In  further  support  of  the  statement  that  the  learned  members 
of  the  bar  have  no  confidence  in  the  correctness  of  this  theory,  I 
will  call  your  attention  to  the  following  remarks  of  Prosecuting 


19 

Attorney '  J.  N.  E.  Wilson,  in  a  case  recently  tried  in  one  of  our 
Superior  Courts,  of  the  People  v.  Kennedy.  He  says  :  "  Rumor 
has  it  that  defendant's  counsel  possesses  one  of  the  finest  medical 
libraries  on  the  coast.  Rumor  also  says  that  the  honorable  gen- 
tleman boxed  it  up  and  stowed  it  away  when  he  commenced  this 
case,  because  he  was  fully  aware  that  no  such  thing  as  '  emotional 
insanity '  could  be  found  in  it.  But  he  goes  on  with  the  case, 
and  instead  of  calling  it  'emotional  insanity,'  gives  it  the  title  of 
'disordered  mental  design.'  '  This  satire  would  probably  have 
been  enjoyed  by  the  learned  attorney  had  his  position  been  re- 
versed in  this  case,  as  on  a  former  occasion  he  had  evoked  an 
adverse  decision  from  the  Supreme  Court  upon  a  question  in- 
volving a  similar  theory. 

In  the  62,  California  Reports,  page  123,  in  the  case  of  the 
People  vs.  T.  J.  Hein,  Judge  McKinstry,  in  giving  his  decision, 
says  :  "  It  will  be  seen  that  the  English  courts  have  refused  to 
recognize  the  co-existence  of  an  impulse  absolutely  irresistible, 
with  capacity  to  distinguish  between  right  and  wrong  with  refer- 
ence to  the  act.  It  cannot  be  said  to  be  irresistible  because  not 
resisted.  Whatever  may  be  the  abstract  truth,  the  law  has  never 
recognized  an  impulse  as  uncontrollable,  which  yet  leaves  the 
reasoning  powers,  including  the  capacity  to  appreciate  the  na- 
ture and  quality  of  the  particular  act,  unaffected  by  mental  dis- 
ease. No  different  rule  has  been  adopted  by  American  courts." 
This  was  concurred  in  by  Morrison,  C.-J.,  Myrick,  Sharpstein, 
Ross,  and  McKee,  J.J.,  and  was  a  complete  answer  to  a  question 
asked  by  Judge  Darwin  pending  the  trial. 

The  New  York  courts  hold  to  the  same  doctrine,  as  appears  in 
the  New  York  Reports  in  the  Court  of  Appeals,  page  469,  in  the 
case  of  Mark  Flannagan,  Plaintiff  in  Error  v.  the  People:  "In 
this  case  all  the  judges  except  one  concurred  in  the  opinion  of 
judge  Tindall,  C.  J.,  and  the  case  is  of  the  highest  authority ;  and 


20 

the   rule   declared   in   it   has   been   adhered  to   by   the    English 
courts." 

IRRESISTIBLE    IMPULSE    ILLUSTRATED. 

When  the  staging  gives  way,  the  irresistible  force  of  gravita- 
tion causes  the  laborer  to  fall  to  the  ground  ;  and  when  this  force 
is  overcome  by  inflating  a  balloon  with  a  much  lighter  air  than 
that  which  surrounds  the  earth,  those  who  leave  in  the  basket 
prepared  for  an  aerial  flight,  are  irresistibly  borne  far  away 
among  the  clouds.  In  one  case  the  irresistible  force  is  a  fixed 
law  of  nature  ;  the  other  simply  a  relative  force,  subjective  to 
chemistry  and  mechanics,  and  is  a  part  of  experimental  life.  But 
by  taking  the  necessary  precaution,  the  voluntary  danger  and 
the  involuntary  act  of  falling  may  both  be  averted.  This  simile 
will  apply  to  the  so-called  irresistible  impulsive  acts  of  men, 
which  are  no  more  than  unresisted  acts,  which  may  be  avoided. 
In  one  case  the  act  is  voluntary,  in  the  other  involuntary ;  but  if 
the  party  falling  is  injured,  he  is  responsible  in  the  one  case  by 
his  folly,  in  the  other  by  his  carelessness,  and  cannot  escape 
responsibility  in  either  ;  for  vigilance  and  prudence  would  have 
enabled  him  to  remain  unharmed,  since  he  could  not  be  raised 
into  the  basket  nor  lifted  upon  the  staging  by  any  irresistible 
force,  while  knowing  the  act  he  was  performing  (idiots  always 
excepted). .  If  a  man  is  seized  with  a  spasm  of  anger  and  kills 
his  brother,  he  must  be  held  responsible,  and  should  be  sent  to 
one  of  the  lunatic  asylums  for  life,  for  he  voluntarily  steps  into 
the  basket  to  be  borne  away  by  the  balloon,  inflated  with  rage  ; 
or,  his  voluntary  involution  causes  him  to  fall. 

It  would  be  a  dangerous  doctrine  to  establish,  to  say  a  person 
was  competent  to  determine  right  from  wrong  in  any  particular 
act,  and  at  the  same  time  was  impelled  by  an  irresistible  foe,  un- 
seen and  unappreciable,  which  was  urging  him  on,  vis  a  tergo, 
to  commit  a  crime  which  he  was  capable  of  appreciating,  and 


21 

realizing  the  consequence  of  its  commission,  and  yet  was  not 
responsible  for  the  act. 

No  man  arms  himself  with  a  pistol  or  knife  and  visits  the  house 
of  another  party  whom  he  suddenly  kills,  without  knowing  what 
he  is  doing,  and  what  he  intended  to  do  before  leaving  on  his 
mission  of  crime,  unless  he  was  insane  before  and  remains  insane 
after  the  act. 

Alfred  Swain  Taylor,  in  his  work  on  Medical  Jurisprudence, 
says:  "The  main  character  of  insanity  in  a  legal  view,  is  said  to 
be  the  existence  of  a  delusion,  i.  <?.,  that  a  person  should  believe 
something  to  exist  which  does  not  exist,  and  that  he  should  act 
upon  this  belief." 

But  if  the  theory  of  mania  transitoria  be  correct,  the  party  so 
attacked  does  not  have  time  to  indulge  even  in  a  belief  of  a  de- 
lusion, but  steps  out  of  himself  for  a  moment  to  give  the  body  an 
opportunity  to  act  and  kill  some  one,  and  then  steps  back  again 
just  in  time  to  take  the  body  away  in  a  perfectly  healthy  con- 
dition, uninjured  by  the  sudden  transition,  from  a  subjective 
agent  to  an  independent  actor  and  vice  versa.  Now  can  any- 
thing be  more  absurd?  Yet  many  intelligent  medical  gentlemen 
have  been  upon  the  witness  stand  as  experts,  and  testified  be- 
fore courts  and  juries  to  the  existence  of  this  mental  condition — 
this  psychic  ledgerdemain  which  is  beyond  the  reach  of  mental 
philosophy  to  explain. 

Such  testimony  is  the  opprobrium  medicorumvi  the  profession, 
while  the  atmosphere  is  redolent  with  inquisitive  objections  to 
such  assumptions  of  learning.  The  highest  medical  authority 
has  never  undertaken  to  prove  by  any  known  physiological  or 
psychic  laws,  how  such  a  mental  condition  can  possibly  have  an 
existence  as  transitory  mania. 

But  in  a  strictly  medical  view,  insanity  does  not  exist  in  the 
mind  per  se,  for  that  is  not  ipse  facto  diseased,  but  is  dependent 


22 

for  its  aberrations  upon  some  abnormal  condition  of  the  physical 
man,  which  may  be  either  organic  or  functional,  and  usually 
found  in  a  change  in  the  structure  of  the  brain  and  the  surrounding 
tissues.  By  reflex  action  the  erethism  of  remote  organs  may  be 
conveyed  to  the  brain,  over- stimulating  the  whole  mass,  or  cer- 
tain ganglia  corresponding  to  the  seat  of  nervous  activity,  which 
supplies  the  organs  effected  with  their  sentient  and  motive  sensi- 
bility, or  automatic  consciousness.  And  often  the  dyscrasia  ot 
the  party,  without  any  localized  morbid  change,  effects  the  vital 
aura  and  periphery  of  the  entire  nervous  system,  producing 
hyperaemia  of  the  brain,  followed  by  disordered  mental  manifest- 
ations. 

As  before  stated,  the  mind  is  not,  ipse  facto,  diseased.  Here, 
I  apprehend,  lies  much  of  the  error  and  perplexity  experienced 
by  witnesses  who  attempt  to  define  a  disease  of  something  that 
exists  but  has  no  length  or  breadth,  the  same  as  they  would  de- 
fine the  disease  of  the  atmosphere,  which  is  rendered  toxic  by 
the  introduction  of  noxious  gases  during  respiration  of  animals 
or  vegetation,  or  from  the  exhalations  of  forests,  or  other  causes, 
by  which  the  oxygen  is  displaced  and  a  new  compound  formed, 
that  enters  the  lungs ;  or  by  heat,  which  lessens  the  volume  of 
oxygen  without  changing  its  ratio  as  the  air  becomes  rarified  and 
expanded.  Such  a  course  of  logic  cannot  be  maintained,  for  the 
elements  of  mind  are  not  tangible,  like  the  odor  of  flowers.  The 
difficulty  of  understanding  this  question  and  not  being  under- 
stood, is  in  consequence  of  not  recognizing  the  truth  of  the  adage, 
mens  sana  in  corpore  sano. 

Cases  of  insanity  following  the  use  of  alcohol  or  opium  are 
always  preceded  by  delirium,  showing  that  changes  do  take 
place  in  the  brain  from  over-excitement,  until  a  permanent  lesion 
is  formed  and  becomes  localized.  The  same  may  be  said  of  in- 
sanity arising  from  cerebro-typhoid  fever,  supervening  upon  dis- 


appointment  and  business  losses,  all  of  which  are  the  psychic 
manifestations  of  physical  disease. 

After -carefully  studying  the  functions  of  the  mind,  \vhich  ren- 
der it  voluntary  or  involuntary,  I  fail  to  find  any  evidence  to 
prove  the  existence  of  transitory  mania,  beyond  the  declarations 
of  the  criminals  themselves. 

Such  opinions,  which  have  become  quite  too  popular  for  the 
public  good,  and  upon  which  often  rest  verdicts  of  juries,  appear 
to  have  been  formed  and  agreed  upon  to  meet  certain  cases  after 
deeds  of  violence  had  been  committed,  and  are  purely  ex  post 
facto.  When  there  is  a  temporary  suspension  of  the  conscious 
action  of  the  will,  affecting  any  of  the  moral  sentiments,  no  harm 
can  possibly  be  done ;  for  the  'consciousness  of  an  idea  to  act  is 
lost.  And  when  the  suspension  of  the  will-power,  from  what- 
ever cause,  affects  the  physical  forces,  motion  is  irregular,  and 
seldom  in  a  direct  line  of  action ;  the  motor  nerves  always  mani- 
festing a  volitional  disturbance,  as  witnessed  in  paralysis  agitans, 
and  it  is  not  possible  for  the  will  to  be  suspended  in  the  middle 
ol  an  arc,  being  described  in  the  act  of  a  blow  and  before  its  com- 
pletion, and  again  suddenly  regain  its  full  force  the  moment  the 
act  is  performed.  Such  doctrine  would  be  dangerous,  and,  if 
maintained,  would  render  our  criminal  courts  powerless  to  ad- 
minister justice,  and  the  physician  should  be  held  largely  respon- 
sible for  encouraging  it. 

In  this  theory  we  find  all  that  supports  the  argument  in  favor 
of  transitory  mania,  which  in  a  spirit  of  great  generosity  should 
be  considered  only  as  transitory  cussedness,  in  distinction  to  other 
vicious  traits,  and  differing  from  moral  depravity  in  many  of  the 
essentials  by  which  man  is -recognized  as  being  endowed  with  a 
moral  and  physical  nature. 

We  are  told  that  "charity  is  kind  and  of  long  suffering,"  and 
that  it  is  better  that  "  ten  guilty  persons  should  go  free  than  that 


24 

one  innocent  party  should  suffer."  This,  as  an  expression  of  a 
Christian  mind,  and  in  accordance  with  church  ethics,  is  well 
enough ;  but  when  we  devise  some  theory  by  which  the 
guilty  may  go  unpunished,  we  encourage  the  infraction  of  law 
and  degrade  public  morals,  which  is  not  in  accordance  with  the 
teachings  of  the  gospel  of  Christ,  or  any  sentiment  of  morality. 

Whatever  theories  are  advanced  in  regard  to  the  insane,  there 
must  survive  a  consciousness  of  some  sentiment  in  the  mind  ot 
every  intelligent  person,  and  a  feeling  of  regret  for  the  wrongs  ot 
the  aggressor,  which  leads  one  to  desire  to  remedy  all  within 
human  power  that  is  wrong  ;  and  to  be  just,  we  must  remember 
the  offended  have  rights  that  must  be  respected,  and  we  must  be 
prepared  to  prove  the  existence  of  some  conscious  reality  behind 
every  act,  as  well  as  that  which  follows  a  crime,  and  vice  versa. 

As  we  become  more  familiar  with  the  social  influences  of  life, 
which  shape  the  course  of  individual  action,  the  more  we  are 
impressed  that  life  itself  is  a  mimicry  as  related  to  the  daily 
affairs  in  which  we  are  most  interested ;  and  it  is  of  the  most 
profound  importance  that  we  should  make  ourselves  familiar 
with  all  the  possible  details  of  pathology,  that  we  may  become 
competent  judges  of  the  functions  of  health  and  disease,  and  be 
able  to  determine  their  influence  over  the  moral  and  mental 
forces  which  determine  the  nature  of  human  action.  Here  is 
where  we  can  maintain  an  honorable  distinction  above  the 
average  witness,  and  render  valuable  service  to  an  honorable 
and  learned  profession  in  the  halls  of  justice,  in  the  interest  of 
public  morals  and  human  safety. 

What  is  involuntary  action,  and  what  emotional  ?  Involuntary 
action  is  witnessed  in  respiration,  nictation,  pulsations  of  the 
heart  and  spasms  of  tetanus.  Emotional  action  is  seen  in  weep- 
ing, sighing,  and  laughing.  The  difference  is  found,  in  the  fact 
that  the  former  acts  are  without  any  conscious  effort  of  the  will ; 


25 

while  the  latter  acts  are  dependent  upon  impressions  made  upon 
the  mind  by  surrounding  influences,  as  reading,  seeing,  or  hear- 
ing some  sad  or  mirthful  story.  And  while  these  manifestations 
cannot  be  wholly  controlled  by  the  will  at  the  moment  of  occur- 
rence, they  are  not  involuntary,  since  the  volition  is  active  and 
conveys  impressions  to  the  seat  of  the  mind,  which  arouse  reflec- 
tions of  pleasures  or  pain. 

If  the  prism  through  which  the  rays  of  light  pass  is  defective, 
there  will  not  be  a  homogeneity  of  colors  produced,  and  this 
condition  will  confuse  and  antagonize  the  science  of  dioptrics, 
and  of  the  solar  spectrum  in  the  simple  multiple  rays  or  factors, 
which  unify  the  rays  of  light  around  us,  or  separate  them  into 
primitive  colors;  and  this  theory  holds  good  in  the  various 
cognate  branches  of  science,  and  in  mental  pathology. 

We  do  not  see  light,  but  realize  its  presence,  and  recognize 
distances  by  the  eye  ;  nor  do  we  see  mind,  but  recognize  its  force 
by  the  effect  it  has  upon  others  in  the  silent  language  of  inven- 
tion, and  social  and  political  leadership,  and  realize  its  changes 
by  the  tone  of  the  voice,  the  laugh,  the  smile,  the  tears  or  sighs; 
and  can  read  the  unwritten  law,  governing  mind  by  voluntary 
action,  as  we  judge  of  heat  and  magnetism  by  their  effect  upon 
vegetable  and  animal  life.  All  disorders  of  the  mind  are  so 
many  evidences  of  molecular  perturbations  of  physical  forces,  de- 
pendent upon  some  positive  lesions  ol  the  anatomical  structure 
of  the  brain,  or  of  those  organs  and  functions  which  exercise  a 
strong  controlling  influence  over  the  same.  Hence  we  may  reason- 
ably infer  there  can  be  no  insanity  arising  from  the  mind  per  se, 
beyond  its  influence  upon  some  of  the  physical  functions ;  and  alt 
the  manifestations  of  anger,  hate,  frenzy  and  impulse,  or  emotion 
of  whatever  nature,  are  volitional,  and  subjective  to  a  proper  exer- 
cise and  control  of  the  will,  and  man  is  responsible  for  their  con- 
sequences. 


26 
IH'TY    OF    PHYSICIANS. 

It  is  as  much  the  province  of  the  physician  to  endeavor  to 
have  the  criminally  insane  taken  care  of,  as  to  advise  measures 
for  the  care  of  those  who  are  incapacitated  from  any  of  the  cas- 
ualities  of  life,  and  I  would  recommend  that  the  committee  of 
this  society  on  legislation  be  especially  instructed  to  endeavor 
to  secure  the  passage  of  an  act,  to  provide  for  the  care  of  the 
insane  criminal  .in  a  separate  building  from  the  morally  insane. 
I  would  also  recommend  that  the  law  of  Massachusetts  upon  this 
subject  shall  form  the  basis  of  such  legislation. 

The  law  reads. as  follows,  viz: 

SEC.  20. — "When  a  person  indicted  for  murder  or  manslaughter  is 
acquitted  by  the  jury  by  reason  of  insanity,  the  court  shall  cause  such 
person  to  be  committed  to  one  of  the  State  lunatic  hospitals  during  his 
natural  life." 

SEC.  21. — "Any  person  committed  to  a  State  lunatic  hospital  under 
the  foregoing  section  may  be  discharged  therefrom  by  the  Governor,  by 
and  with  the  consent  of  the  Council,  when  he  is  satisfied  that  such  person 
may  be  discharged  without  danger  to  others." — General  Statutes,  chap- 
ter 214. 

In  kleptomania  there  can  be  no  real  motive  to  wrong  another 
•or  acquire  the  stolen  property,  for  motive  must  be  prompted  by 
an  idea  of  revenge,  or  some  possible  advantage,  and  things  are 
often  stolen  which  can  be  of  no  possible  benefit  to  the  parties  who 
steal.  In  pyromania  the  party  applies  the  torch  to  the  building 
without  a  motive  to  harm  another.  In  the  former  case  the 
stolen  goods  are  concealed,  and  in  the  latter  the  property  is  de- 
stroyed, and  no  benefit  is  to  be  gained  by  the  commission  of 
crime  to  either  party,  nor  is  there  any  fixed  motive  for  the  crime. 

But  the  absence  of  a  motive  to  be  benefited  or  to  injure  another 
does  not  make  the  offense  less  punishable  under  common  law 
by  placing  the  parties  under  restraint. 

Then,  admitting  the  theory  of  transitory  mania  to  be  correct, 


27 

and  that  homicides  are  committed  without  a  motive  of  gain  or 
injury  to  another,  and  the  absurdity  of  the  law  that  punishes  the 
former  and  acquits  the  latter  is  readily  apparent,  and  the  theory 
of  transitory  mania  is  made  to  appear  ridiculous. 

Taylor  (page  674)  remarks:  "It  cannot  be  denied  that  the 
doctrine  of  '  irresistible  impulse '  has  been  strained  in  recent  times 
to  such  a  degree  as  to  create  a  justifiable  distrust  of  medical  evi- 
dence on  these  occasions." 

"  It  is  obviously  easy  to  convert  this  into  a  plea  for  the  exten-' 
nation  of  all  kinds  of  crime  for  which  motives  are  not  apparent, 
and  thus  medical  witnesses  often  expose  themselves  to  severe 
rebuke.  They  are  certainly  not  justified  in  setting  up  such  a 
defence  unless  they  are  prepared  to  draw  a  clear  and  common - 
.sense  distinction  between  impulses  which  are  unresisted  and  those 
which  are  irresistible.''' 

This  irresistible  theory  would  deprive  a  man  of  his  individu- 
ality, and  make  him  a  frail  instrument  in  the  hands  of  an  un- 
known foe,  and  subvert  public  morals,  pervert  the  purest  prin- 
ciples of  law,  and  endanger  human  life. 

Maudsley  says  :  "  Many  cases  of  the  so-called  transitory  mania 
are  really  cases  of  mental  epilepsy,"  and  cites  a  case  of  a  patient 
in  the  French  Asylum  at  Avignon.  A  similar  case  is  related  by 
Esquirol  of  a  Swabian  peasant  who  killed  his  mother  (page  234). 

Falret  describes  epileptic  vertigo  as  a  sort  of  petit  mal,  or  tran- 
sitory disease,  with  no  pathology  :  "  These  peculiar  states  of  epi- 
leptic consciousness  are  not  only  of  great  psychological  interest, 
but  also  of  practical  consequence  in  relation  to  the  question  of 
responsibility,  for  it  is  obvious  that  deeds  might  be  done  by  an 
individual  when  in  an  anomalous  state  of  consciousness,  of  which 
he  might  have  no  remembrance  when  in  his  really  normal 
state,  and  for  which  he  could  not  justly  be  held  responsible. "- 
Maudsley,  page  238. 


28 

It  seems  from  the  foregoing  that  the  author  considers 
transitory  mania  to  be  of  an  epileptic  nature  entirely.  From  this 
view  of  the  question  I  do  not  dissent,  it  being  one  of  the 
paroxysmal  manifestations  of  a  disease  known  to  exist,  as  de- 
lirium is  the  result  of  fever  and  hyper-stimulation  of  the  brain 
in  intoxication,  and  nothing  more. 

In  all  such  cases  there  are  prodromata,  or  physical  conditions 
existing,  which  affect  the  normal  status  of  the  will,  and  which 
antedate  acts  of  violence ;  and  those  thus  affected  do  not  find 
their  remedy  and  cure  in  the  act  itself,  as  has  been  often  alleged 
by  those  who  desire  to  acquit  the  homicide  upon  the  plea  of 
transitory  mania,  and  who  declare  the  actor  is  instantly  restored 
to  consciousness  after  a  deed  of  violence  is  committed. 

J.  H.  Balfour  Browne,  page  170,  says:  "Again,  such  a  disease 
as  transitory  mania,  mania  which  suddenly  appears  and  suddenly 
disappears,  is,  to  our  thinking,  an  impossibility." 

Dr.  Hammond  remarks  :  "  The  doctrine  that  an  individual 
can  be  entirely  sane  immediately  before  and  after  any  particular 
act,  and  yet  insane  at  the  instant  the  act  was  committed,  is  con- 
trary to  every  principle  of  sound  psychological  science." 

Even  in  the  most  striking  instances  of  what  is  called  transitory 
mania  or  morbid  impulse,  the  evidence  of  pre-existent  and  subse- 
quent disease  of  the  brain  will  be  found  if  looked  for  with  dili- 
gence and  intelligence. 

Dr.  Gray,  a  distinguished  authori  y,  says  :  "  I  am  not  going 
to  deny  the  existence  of  transitory  paroxysms  in  insanity,  either 
in  epilepsy  or  in  the  frenzy  of  melancholia,  or  in  ordinary  cases 
of  insanity  where  paroxysms  suddenly  arise  and  suddenly  disap- 
pear ;  but  until  I  have  seen  more  than  I  have  yet  seen,  and  until 
I  have  read  something  more  authentic  than  I  have  yet  read,  I 
must  fail  to  see  insanity  in  any  case  which  arises  when  the  pre- 
monitory symptoms  of  the  disease  run  the  rapid  course  of  a  few 
minutes,  when  the  person  commits  a  crime  and  then  is  well." 


29 

E.  C.  Spitzka,  in  his  work  on  Insanity,  published  1883,,  page 
154,  says:  "Numerous  instances  are  recorded  where  persons, 
previously  of  sound  mental  health,  have  suddenly  broken  out  in 
a  blind  fury  or  confused  delirium,  which,  passing  away  in  a  few 
minutes  or  hours,  left  the  subject  deprived  of  a  clear,  or  any, 
recollection  of  the  morbid  period,  and  generally  concluded  with 
a  deep  sleep."  These  conditions  are  witnessed  in  cases  of  con- 
cussions of  the  brain,  when  a  person  remains  unconscious  for  a 
longer  or  shorter  period,  and  upon  being  restored  to  conscious- 
ness has  no  recollection  of  what  has  occurred,  with  the  exception 
that  no  fury  is  manifested. 

This  author  says  "observers  designate  this  condition  as  tran- 
sitory mania."  "Others  term  it  transitory  melancholia,  and 
others  class  it  among  epileptic  disorders."  But  to  our  thinking 
it  should  be  classed  with  hysteria,  dependent  upon  the  inhibition 
of  the  nerve  centres  and  reflex  action. 

The  same  author  says,  page  155:  "But  it  would  have  to  be 
considered  a  remarkable  form  of  epilepsy  in  which  there  was  but 
a  single  epileptic  attack."  "Transitory  mania,  or  frenzy,  is  a 
•comparatively  rare  affection,  so  rare  that  many  asylum  physi- 
cians have  never  seen  a  case  of  it ;  the  writer  has  likewise  never 
had  that  fortune."  According  to  the  same  author,  "  Foville,  in 
his  'Annales  Medico- Psychologiques1  of  1874,  declares  moral 
insanity  and  mania  transitory  false,  absurd,  ridiculous,  and  above 
all,  unworthy  of  being  received  by  the  courts." 

Cook,  another  author,  claims  that  "  transitory  mania  is  a  cereb- 
ral epilepsy." 

Kinnon  says :  ' '  You  cannot  prove  the  epilepsy  ;  you  can 
prove  the  mania,  and  it  is  transient;"  "and  is  it  not  as  easy  to 
accept  the  theory  of  transitory  mania  as  it  is  to  go  wandering 
after  a  far-fetched  forced  explanation  ?"  In  reply  I  would  say, 
it  is  easier  to  accept  this  declaration  than  to  undertake  the  labor 


UWIRSITT] 


30 

of  proving  or  disproving  its  correctness ;  but  it  is  not  in  accord- 
ance with  the  spirit  of  fair  inquiry  to  admit  anything  that  'is  not 
proven,  for  no  axioms  upon  these  questions  are  presented  for  our 
guidance  that  have  not  been  tested  in  the  crucible  of  science.  A 
simple  declaration  of  the  existence  of  anything  does  not  establish 
a  fact,  any  more  than  the  declaration  of  an  action  constitutes  an 
act.  We  are  not  prompted  by  any  spasm  of  curiosity  or  ag- 
gressiveness, but  are  investigating  this  subject  in  a  spirit  of  great 
kindness  and  sympathy  for  the  unfortunate,  and  that  we  may  be 
better  prepared  to  assist  the  courts  in  the  just  administration  of 
the  law  when  called  upon,  when  the  plea  of  the  defence  is  transi- 
tory mania  ;  for  now  there  seems  to  be  a  greater  effort  to  shield 
the  guilty  than  to  protect  the  innocent. 

From  our  knowledge  of  the  functions  of  the  brain  and  the 
media  through  which  psychic  and  volitional  forces  pass,  we  have 
before  us  evidence  to  show  that  outward  manifestations  of  vio- 
lence are  in  consequence  of  a  disturbance  of  the  vaso-motor 
centres  which  lie  along  the  floor  of  the  fourth  ventricle,  and  are 
imbedded- in  the  gray  corticle  of  the  spinal  cord,  and  from  an 
over  excitation  of  all  or  any  of  the  cerebral  ganglia,  and  whatever 
disturbs  the  substance  of  the  brain. 

The  daily  panorama  of  the  changing  scenes  of  life  is  forever 
making  impressions  upon  the  mind  for  pleasure  or  pain,  as  the 
strong  rays  of  the  sun  produce  photophobia  or  give  pleasure  as 
one  gazes  upon  the  scenes  of  an  outspreading  landscape.  Or  the 
brain  may  become  so  acted  upon  that  the  mind  will  lose  its  power 
of  discriminating  judgment  of  colors,  forms,  and  objects,  through 
the  defective  medium  of  sight,  occasioned  by  straining  the  eye, 
or  in  astigmatism,  or  double  dyplopia,  when  errors  of  vision  be- 
come provocative  causes  of  mental  alienation,  as  the  optic  lobes 
are  falsely  stimulated  by  the  imperfect  image  upon  .the 
retina  coming  through  the  refractive  media  of  an  astigmatic 
eye. 


This  effect  is  not  wholly  confined  to  the  optic  lobes.  Stimuli,, 
if  sufficiently  strong,  applied  to  the  afferant  nerves,  will  inhibit, 
/.  e.,  "  will  retard  or  even  wholly  prevent  reflex  action"  (Pastor, 
page  419).  These  facts  may  be  applied  to  the  reflex  action  of 
psychic  forces  which  awaken  another  train  of  errors  in  judgment, 
and  can  only  be  overcome  by  a  careful  course  of  reasoning.  But 
an  error  of  judgment,  however  persistently  followed,  must  not 
be  received  a§  an  evidence  of  insanity. 

DELUSION    AND  HALLUCINATION. 

Delusion  is  a  deception  as  regards  the  existence  of  truths. 
Hallucination  is  a  deception  as  regards  the  existence  of  things. 
The  former  relates  to  abstract,  the  latter  to  concrete  sub- 
jects. For  instance,  I  am  told  of  the  existence  of  a  great  con- 
flagration, and  believe  it,  but  afterwards  I  find  it  did  not  exist 
and  that  I  was  deluded;  again,  I  think  I  see  a  conflagration,  and 
repeat  my  impressions  of  its  magnitude,  but  afterwards  find  it  did 
not  occur,  and  then  learn  I  was  laboring  under  an  hallucination. 

All  tha.t  appeals  to  reason  and  judgment  through  mental 
activity  alone,  that  is  not  true,  is  a  delusion — all  that  is  presented 
to  the  mind  through  physical  senses,  that  is  not  true,  is  hallucina- 
tion. 

Delusions  arise  frequently  from  physical  causes,  as  one  with  an 
astigmatic  eye,  which  is  unassisted  by  proper  lens,  regards  all 
round  objects  or  circles  as  oblong  ;  also,  where  there  is  an  imperfect 
formation  of  the  membrana  tympani,  sound  awakens  an  error 
of  judgment  as  to  its  intensity  and  kind.  When  odoriferous 
particles  fall  upon  the  olfactory  epithelium  the  sensation  of  smell 
is  produced;  but  if  this  membrane  be  diseased,  there  will  be  an 
error  conveyed  to  the  sensorium,  the  same  as  occurs  when  there 
is  a  deformity  of  the  retina  in  the  objective  sphere  of  vision. 

These  are  some  of  the  external  and  concentric  causes  of  error 
of  judgment,  and  serve  to  illustrate  how  disease  or  over-excitation 


32 

-of  the  cerebral  nerve  centres  produce  insanity  or  strong 
emotional  feelings,  according  to  the  various  media  through 
which  the  vibratory  excitement  passes,  but  do  not  show  where 
responsibility  ceases. 

Who  cannot  recall  the  memory  of  childhood  with  its  scenes  of 
pleasure  or  fear  of  parental  discipline.  At  will,  the  whole 
panorama  of  life,  with  its  daily  etchings  and  embellishments,  is 
brought  before  us  to  be  with  its  original  thoug-ht  again  com- 
pressed amid  the  subtle  forces  of  an  undefined  existence;  and 
we  search  nowhere  but  the  brain  for  the  forces  which  give 
character  and  direction  to  all  the  affairs  of  life,  and  hold  all  in  re- 
serve for  the  use  of  memory. 

Physiologists  distinguish  two  kinds  of  nervous  action  ;  one 
initiatory,  the  other  inhibitory — the  one  originating,  the  other 
controlling.  Now,  just  as  the  originating  centres  may  be  strength- 
ened by  indulgence,  so  may  the  inhibitory  be  made  stronger  by 
habit ;  hence,  a  man  in  ordinary  health  may  be  tempted  by  some 
false  inducement  to  act,  but  he  does  not  lose  his  power  to  resist 
the  action.  So  a  man  may  be  tempted  while  suffering  from  dis- 
ease, by  some  unreal  object,  some  delusional  belief,  but  it  does 
not  thereby  follow  that  he  is  deprived  of  the  volitional  power  of 
control  over  his  acts,  and  that  he  is  irresponsible  for  what  he  does 
on  this  account;  for  the  originating  thought  is  the  force  that  con- 
trols all  subsequent  action. 

"  It  is  the  feelings  that  reveal  the  genuine  nature  of  an  individ- 
ual and  the  nature  of  his  acts ;  it  is  from  the  depths  of  one's 
inner  nature  that  the  impulses  of  action  come,  while  the  intellect 
guides  and  controls  ;  and  accordingly  in  a  perversion  of  the  effec- 
tive life  is  revealed  a  fundamental  disorder,  which  will  be  exhib- 
ited in  acts  rather  than  in  words." — Reynolds,  page  592. 

And  here  we  find  a  ready  solution  to  the  problem  of  psychic 
forces,  which  prompt  and  lead  on  to  unresisted  criminal  action, 


33 

the  will  relaxing  its  hold  upon  fortitude  and  right;  but  not  be- 
cause the  unseen  is  an  irresistible  foe  that  compels  the  unfortu- 
nate to  the  commission  of  crime,  but  by  reason  of  the  failure  to 
exercise  the  moral  faculties  which  creative  energy  has  bestowed 
upon  man. 

Not  an  author  which  I  have  consulted  has  attempted  to  prove 
the  pathology  of  transitory  mania,  or  given  any  psychic  or  phys- 
iological reasons  for  their  conclusions  ;  the  ipse  dixit  of  the  indi- 
vidual said  to  be  so  affected,  is  the  only  evidence  given  in  sup- 
port of  the  theory.  And  certainly  this  cannot  be  considered  of 
any  value  in  a  court  of  justice  ;  and  it  is  surprising  that  any  of 
the  eminent  writers  upon  this  subject  should  attach  so  much  im- 
portance to  the  declarations  of  parties  judged  to  be  insane  but  a 
moment  before  and  at  the  time  of  a  criminal  act.  I  do  not  refer 
to  the  spasmodic  homicidal  impulse  of  known  epileptics,  or  of 
the  known  insane,  but  have  special  reference  to  the  mushroom 
development  and  decay  of  a  sui  o-eneris  type  of  insanity  called 
transitory  mania. 

Wharton  and  Stille,  page  710,  say:  "Mania  transitoria  is  a 
sudden  insane  frenzy."  'As  frenzy  disconnected  with  physical 
suffering  can  have  no  possible  pathology,  perse,  it  cannot  properly 
be  held  to  be  insanity,  and  should  not  be  offered  as  an  extenuating 
excuse  for  crime;  for,  being  considered  as  a  purely  mental  dis- 
turbance, it  is  only  an  increased  state  of  unresisted  passion. 

Chitty,  Forsyth,  andj.  T.  N.  Fontblanque  make  no  mention  of 
transitory  mania. 

Allan  McLane  Hamilton,  physician  to  the  Insane  Asylum  ot 
New  York,  says  (page  209) :  ' '  When  a  crime  is  not  to  be  ac- 
counted for,  and  completely  inconsistent  with  the  antecedents  of 
one  who  is  not  knowrn  to  be  epileptic  or  insane,  and  when  it  is 
accomplished  in  a  moment  of  fury,  then  we  should  examine 
whether  these  are  aborted  or  nocturnal  attacks  of  epilepsy." 


34 

"  Maniacal  rage  of  short  duration  is  often  epileptic  in  character, 
and  its  true  character  is  often  mistaken.' ' 

This  author  does  not  treat  of  transitory  mania  beyond  this 
epileptic  form  of  disease,  and  is  wisely  cautious  about  admitting 
its  possibility,  rendering  his  opinion  of  doubtful  value  upon  any 
medico-legal  question. 

Ray,  in  his  work  entitled  "Contributions  to  Medical  Path- 
ology," page  259,  in  the  case  of  Bernard  Congley,  says  :  "  It 
must  have  been  a  paroxysm  of  transitory  mania,  suddenly  begin- 
ning and  as  suddenly  ending,  after  the  briefest  possible  duration. 
The  cases  of  this  kind  of  mania  on  record,  though  few,  certainly 
are  so  well  attested  that  we  can  scarcely  deny  the  existence  of  the 
form  of  insanity  which  they  illustrate.  And  it  is  a  noticeable 
feature  of  most  of  them  that  the  patient  is  bent  on  destroying 
life." 

If  bent  upon  committing  murder,  that  fact  implies  the  exercise 
of  the  will  to  accomplish  some  specific  object;  consequently  his 
theory,  if  analyzed,  would  scarcely  bear  the  crucial  test,  so  as  to 
be  entitled  to  any  more  importance  to  the  profession  than  the 
declaration  of  some  less  learned  gentleman. 

REPORT    OF    TRIAL    OF    SAMUEL    M.    ANDREWS,    BEFORE    THE 
SUPREME    COURT    OF    MASSACHUSETTS. 

Dr.  Edward  Jarvis  (page  173)  testified:  "Sudden  manias 
vary ;  sometimes  they  commence  and  terminate  in  a  violent 
outbreak.  They  may  come  suddenly  and  cease  as  abruptly." 

In  the  same  case,  page  187,  George  H.  Choate  testified:  "I 
have  had  about  3,600  cases  under  my  charge."  "I  have  never 
known  a  case  of  insanity  originating  and  terminating  in  a  single 
act  of  violence.  I  don't  believe  such  a  case  exists." 

Page  1 88:  "There  is  a  moment  when  insanity  begins.  There 
is  a  gradual  increase  of  symptoms,  and  it  does  not  reach  uncon- 
sciousness without  increasing  symptoms." 


35 

Here  we  have  directly  opposite  opinions  from  two  eminent 
medical  gentlemen,  the  one  having  the  greater  advantage  over 
the  other  by  his  superior  opportunities  for  observation,  and  he 
positively  denies  \\\e  possible  existence  of  transitory  mania.  But, 
like  all  other  authorities  upon  insanity,  they  make  no  attempt  to 
prove,  by  any  method  of  reasoning,  why  this  condition  may  or 
cannot  exist  as  a  sequence  of  functional  or  organic  disturbances. 
This  is  a  part  of  the  labor  I  have  undertaken  in  preparing  this 
paper. 

In  order  to  obtain  an  expression  upon  this  subject  from  those 
best  qualified  to  judge,  I  addressed  a  "circular  letter  "to  the 
Superintendents  of  all  the  Insane  Asylums  of  our  country,  and 
requested  them  to  answer  the  following  interrogatories,  viz  : 

1.  How  long  have  )  on  been  connected  with  any  institution  for  the 
treatment  of  the  insane? 

2.  Have  you  ever  seen  a  case  of  transitory  mania  that  was  not  depen- 
dent upon  some  form  of  insanity,  and  that  did  not  present  itself  as  a 
manifestation  of  previously  existing  disease? 

3.  Do  you  consider  it  possible  for  transitory  mania  to  occur  as  an  idio- 
pathic  disease  ? 

4.  How  many  insane  persons  have  you  had  under  your  care? 
Remarks. 

To  these  questions  I  have  received  the  following  replies.  To 
avoid  repetition  I  will  place  the  answers  in  the  order  of  i,  2,  3 
and  4,  as  the  questions  were  given  : 

i — Seven  years.  2 — I  do  not  recollect  such  a  case.  3 — Possible  ;  not 
probable.  4 — 650.  Remarks  :  I  have  been  of  the  opinion  that  tran- 
sitory mania  may  occur,  but  in  very  exceptional  cases. — H.  Wardner, 
M.D.,  Supt.  Hospital  for  the  Insane,  Anna,  III. 

i — Eleven  years.  2— Not  one.  3 — Think  not.  4 — 4,946.  Remarks: 
I  have  also  seen  25,000  patients  in  other  asylums,  but  no  case  of  tran- 
sitory mania. — E.  T.  Wilkins,  M.D.,  Resident  Physician  of  Napa  (Call 
fornid]  State  Asylum  for  the  Insane. 


36 

i — Two  years.  2 — No.  3 — No.  4 — 3,787. —  H.  B.  Fletcher,  M.D., 
Insane  Asylum,  Indianapolis,  Ind. 

i— Fifteen  years.  2— No.  3— No.  4—  2,000.— Chas.  P.  Mac  Donald, 
Supt.  State  Asylum  for  Insane  Criminals,  Auburn,  N.  Y. 

i — Seven  years.  2 — Never.  4—1,500,  Remarks:  Transitory  mania 
I  think  is  of  rare  occurrence  ;  that  it  does  sometimes  occur  I  think  there 
is  no  doubt.— C.  W.  King,  M.D.,  Dayton,  Ohio. 

i — Nine  years.  2 — Have  not.  3 — Do  not.  4 — 2,000.  Remarks  :  I  do 
not  believe  mania  transitoria  exists,  per  se. — Randolph  Parksdale,  M.D., 
Supt.  Insane  Asylum,  Petersburgh,  Va. 

i — Twelve  years.  2 — No.  4 — Several  thousand. — D.  M.  Wise,  Supt 
Willard  Asylum  for  the  Insane,  N.  Y. 

i — Sixteen  years.  2 — Most  assuredly  not.  3 — No.  4 — 3,000.  Re- 
marks :  Such  a  proposition  as  transitory  mania  is  irrational,  absurd,  and 
opposed  to  every  theory  of  advanced  psychistry. — E.  A.  KiJburn,  M.D., 
Med.  Supt.  Insane  Hospital,  Elgin,  III. 

i — Twenty  years.  2 — Never.  4 — 7,000.  Remarks  :  To  be  insane 
there  must  be  actual  disease  of  the  brain,  which  is  not  transitory. — H.  A 
Gilman,  M.D.,  Supt.  Insane  Asylum,  Mt.  Pleasant,  Iowa. 

i — Ten  years.  2 — No.  3 — No.  4 — 200.  Remarks  :  I  fully  concur 
with  your  views  on  the  subject. — R.  C.  Chenault,  M.D.,  Med.  Supt.  E. 
V.  L.  Asylum,  Lexington,  Ky. 

i — Sixteen  years.  2 — Never.  3 — No.  4 — 3,602.— John  W.  Ward, 
M.D.,  Trenton,  N.  J. 

i — Eleven  years.  2 — No.  3 — No.  4—1, 297.  — /.  W.  Jones,  Supt.  In- 
sane Asylum  of  Louisiana. 

i — Twenty-five  years.  2 — No.  4 — 2,500.  Remarks  :  While  my  ex- 
perience, as  shown  above,  is  against  the  existence  of  what  you  call  mania 
transitoria,  my  views  of  the  nature  of  mind  make  such  a  condition  scien- 
tifically possible. — P.  Bryce,  M.D.,  Tuscalusa,  Ala. 

i — Eight  years.  2 — No.  4 — 5,000.  Remarks  :  I  have  no  reason  to 
doubt  the  authenticity  of  some  reported  cases  of  transitory  mania.  Ma- 
nia transitoria  differs  somewhat  as  treated  by  different  authors,  and  the 


37 

name  does  not  sufficiently  explain   what  is  meant. —  lb.   P>.    (Goldsmith, 
M.I).,  Danvers,  Mass.,  State  Asylum. 

i — Thirty  years.  4 — Several  thousand.  Remarks  :  Transitory  mania 
as  an  idiopathic  disease  is  not  probable,  judging  from  experience.  I  have 
never  seen  a  case  of  so-called  transitory  mania. — John  B.  Chapin,  M.D., 
Supt.  Hospital  for  Insane,  Phil. 

i — Seven  years.  2 — No.  3 — No.  4 — 699.  Remarks  :  Daily  average 
never  less  than  660.  Your  position  is  correct. — C.  A.  Miller,  M.D.,  Supt. 
Insane  Asylum,  Carthage,  Ohio. 

i — Sixteen  years.  2 — No.  4 — 7,000. — R.  M.  Wigginton,  M.D.,  Supt. 
State  Asylum,  Winnebago,  Wis. 

i — Eleven  years.  2 — No.  3 — No.  4 — 2,500.  Remarks:  I  do  not  be- 
lieve there  is  such  a  condition  as  transitory  mania,  and  think  the  use  of 
the  term  should  be  abandoned. — G.  H.  Hill,  M.D.,  Supt.  of  Insane 
Asylum,  Independence,  Iowa. 

i — Thirteen  years.  2 — No.  4 — 2,700.  Remarks:  My  judgment  in 
suspense  ;  no  such  cases  come  to  asylums. — Richard  Dewey,  Kankakee, 
111. 

i — Twenty-seven  years.  2 — No.  3 — No.  4 — About  6,000.  Remarks  : 
I  think  it  possible  that  there  might  be  temporary  mental  aberration  ; 
should  not  call  it  disease,  but  functional  disturbance. — C.  K.  Bartlett, 
M.D.,  Supt.  Minnesota  Hospital  for  Insane,  St.  Peters,  Minn. 

i— Two  years.  2 — No.  3 — I  do  not.  4 — Some  thousands.  Re- 
marks :  When  any  well-marked  neurosis,  particularly  epilepsy,  can  be 
shown,  it  would  be  difficult  to  disprove  transitory  mania. —  W.  H.  Mays, 
M.D.,  Assistant  Physician  State  Asylum,  Stockton,  Cal. 

Remarks  :  Have  never  seen  a  case,  and  I  do  not  believe  in  the  theory 
of  transitory  mania.— .5.  H.  Talcott,  M.D.,  Middleton,  N.  Y. 

r — Fifteen  years.  2 — No.  3 — No.  4 — Some  thousands.  —James  D. 
Moncure,  M.D.,  Snpf.  Insane  Asylum,  Williamsburgh,  Va. 

i — Thirty  years.  2 — No.  3 — No.  4 — 5,000.  Remarks  :  Do  not  con- 
sider it  possible  for  transitory  mania  to  exist  as  an  idiopathic  disease. 
Yet  I  would  not  deny  the  possibility  of  transient  maniacal  phenomena 


38 

as  a  consequence  of  temporary  physical  conditions. — Pliney  Earlc,  M.  />., 
Supt.  of  the  Stale  Lunatic  Hospital  at  Northampton,  Mass. 

i — Twelve  years.  2 — No.  4 — About  i  ,500.  Remarks  :  Cannot  say 
what  is  or  is  not  possible. — H.  P.  Stevens,  M.D.,  Retreat  for  the  Insane, 
Hartford,  Conn. 

i — Forty-two  years.  4 — 8,000. — H.  A.  Buttolph,  M.D.,  Morris  Plims, 
New  Jersey. 

Accompanying  this  reply  is  a  highly  interesting  letter,  in  which 
the  author  doubts  the  theory  of  transitory  mania,  and  thinks  the 
term  should  be  dropped  and  "insane  impulse"  be  used  in  its 
place. 

i — Twenty-eight  years.  2 — Have  never  seen  such  a  case.  3 — No. 
4 — 3,000.  Remarks:  Neither  experience  nor  reading  lead  me  to  think 
it  possible.  The  only  cases  which  have  come  to  my  knowledge  claimed 
as  transitory  mania  have  been  supported  b>  very  questionable  evidence. 
— /.  P.  Bancroft,  M.D.,  Supt.  Insane  Asylum,  Concord,  N.  H. 

The  gentlemen  who  have  kindly  furnished  me  with  the  fore- 
going statistics  are  highly  esteemed  by  the  medical  profession 
for  their  learning  in  psychological  medicine,  and  their  statements 
are  entitled  to  the  fullest  confidence  as  authority  upon" the  sub- 
ject ;  and,  in  justice  to  offended  law,  we  must  conclude  that  the 
theory  of  mania  transitoria  to  the  criminal  is  like  the  signal  of 
the  mariner,  far  out  to  sea  upon  a  sinking  vessel,  with  no  reason- 
able help  in  view  ;  it  is  the  only  hope  of  relief,  when  human 
sympathy  alone  comes  to  the  rescue,  powerless  to  save  the  inno- 
cent from  the  perils  of  the  wave,  yet  holds  the  guiltv  in  the  em- 
brace of  social  life,  though  he  can  never  be  fully  restored  to  the 
confidence  of  the  people. 

In  the  revised  edition  of  the  "  Medico- Legal  Papers,"  page 
189,  Dr.  Wm.  A.  Hammond  says  :  "  The  sympathetic  system  of 
nerves  has  a  most  important  office  to  perform  in  the  organism, 
and  one  which  in  its  relations  to  the  subject  is  of  very  great  mo- 


39 

merit.  It  is  the  organ  by  which  the  size  of  the  blood-vessels  is 
regarded."  And  on  page  190,  xxi  :  "  Now,  what  is  the  condi- 
tion known  as  transitory  mania  ?  i.  It  may  be  defined  as  a  form 
of  insanity,  in  which  the  individual,  with  or  without  the  exhibi- 
tion of  previous  notable  symptoms,  and  with  or  without  obvious 
exciting  cause,  suddenly  loses  the  control  of  his  will,  during 
which  period  of  non-control  he  commonly  perpetrates  a  criminal 
act,  and  then  as  suddenly  recovers,  more  or  less  completely,  his 
power  of  volition.  2.  Attentive  examination  will  always  reveal 
the  existence  of  symptoms  precursory  to  the  outbreak  which 
constitutes  the  culminating  act,  though  they  may  be  so  slight  as 
to  escape  superficial  examination,  (a)  The  hypothesis,  there- 
fore, that  a  person  may  be  perfectly  sane  one  moment,  insane  the 
next,  and  then  again  perfectly  sane  in  a  moment,  is  contrary  to 
all  the  experience  of  psychological  medicine." 

Page  185  :  "  An  essential  feature  of  the  definition  of  insanity  is 
that  it  depends  directly  upon  a  diseased  condition  of  the  brain." 

' '  Medico-  Legal  papers, ' '  page  221:  "  Whatever  may  be  said  by 
the  pure  psychological  school  of  philosophers,  the  world  is  indebt- 
ed to  physicians  and  physiologists  for  the  only  true  philosophy  of 
mind,  namely,  that  instead  of  being  a  simple  entity,  an  indepen- 
dent source  of  power  and  self-sufficient  cause  of  causes,  it  is  de- 
pendent on  a  material  organ  for  all  its  manifestations." 

"  Mental  power  is  but  an   organized  result,  matured  by  insen- 
sible degrees  in  the  course  of  life,  and  as  much  dependent  on  the 
nervous  structure  as  the  function  of  the  liver  is  on  the  hepatic 
structure." 
Report  of  Abner  Rogers,  Jr.,   indicted  for  the  murder  of  Charles 

Lincoln,  Jr. ,  tried  before  the  Supreme   Court  of  Massachusetts, 

page  104. 

"And  first  as  to  the  point  of  the  State's  attorney,  that  the 
prisoner's  offense,  if  not  amounting  to  murder,  may  yet  consti- 


40 

tute  manslaughter.  That  as  manslaughter  is  murder  upon  pro- 
vocation, or  under  sudden  excitement,  so  murder  on  insane  or 
partially  controllable  impulse,  may  be  no  more  than  manslaugh- 
ter." As  there  can  be  no  such  thing  as  "  partially  controllable 
impulse,"  no  great  wisdom  is  presented  in  this  theory,  nor  evi- 
dence of  careful  investigation  of  mental  disease,  nor  does  it  en- 
lighten the  jury. 

A  great  statesman  of  the  old  country,  Mr.  Burke,  said  that 
"the  soul  of  government  lies  in  the  jury-box."  But  jurors 
should  be  well-informed,  and  competent  to  pass  upon  and  deter- 
mine between  questions  which  relate  to  facts  and  those  which 
relate  to  law  ;  and  experts  upon  questions  of  insanity  should  be 
able  to  make  such  clear  statements  before  them  that  there  should 
be  no  difficulty  in  understanding  the  true  import  of  their  mean- 
ing. But  no  one  can  prove  to  any  jury  that  impulse,  or  emotion, 
is  a  disease  which  only  finds  a  remedy  in  some  criminal  act,  as 
homicide,  and  then  is  instantly  and  forever  cured. 

As  a  matter  of  physiological  interest  connected  with  this  sub- 
ject, and  showing  some  of  the  functions  of  the  brain,  Luys  (page 
53)  remarks:  "  Subject,  who  had  been  long  deprived  of  an  up- 
per limb,  in  the  case  of  disarticulation  of  the  shoulder,  there  ex- 
isted in  certain  long  disused  regions  of  the  brain,  coincident,  very 
distinctly  localized  atrophies.  I  have,  moreover,  demonstrated 
that  the  atrophied  regions  of  the  brain  are  not  the  same  in  the 
case  of  the  amputation  of  the  leg  as  in  that  of  amputation  of  the 
upper  limbs." 

The  researches  of  Feitsch,  Hitzig,  Panier,  Brown-Sequard, 
Bartholow,  and  many  others,  have  shown  that  by  applying  elec- 
tric excitement  in  the  region  of  the  gray  cortex  motor,  reaction 
in  isolated  groups  of  muscles  are  determined ;  that  at  will  we 
may  cause  the  eyes,  tongue  and  neck  to  move. 

The  period  of  incubation  of  reflex  nervous  action  varies,  and 


the  inhibitory  force  of  nervous  activity  is  the  only  important  fac- 
tor which  will  or  can  determine  the  duration  of  physical  disturb- 
ance as  it  relates  to  any  specific  action  dependent  upon  nervous 
energy.  This  is  often  witnessed  in  cerebral  apoplexy,  or  in- 
juries to  the  brain  from  extraneous  causes,  and  shows  in  the 
simplest  manner  the  correlation  between  cause  and  effect.  And 
when  we  apply  these  truths  to  the  inhibition  of  mental  action,  we 
shall  be  able  to  prove  by  physiological  facts  that  spontaneous 
development  of  disease  is  impossible,  as  it  relates  to  growth  and 
decay  at  the  same  moment. 

In  a  work  entitled  "Plain  Talk  about  Insanity,"  by  T.  W. 
Fisher,  M.D.,  page  86,  we  find  the  following,  viz :  "Epileptics 
are  known  to  be  subject  to  attacks  of  frenzy.  This  knowledge 
makes  physicians  careful,  in  cases  of  unexplained  violence,  to 
search  for  some  trace  of  epilepsy,  vertigo,  or  petit  mat,  in  the 
previous  history  of  the  suspected  person,  and  it  is  often  found." 
He  states  that  Dr.  Krafft  Ebbing  "  distinguishes  seven  different 
groups  of  conditions,  under  any  of  which  transitory  mania  may 
occur,"  viz  : 

1.  The  state  of  dreaming. 

2.  Different  kinds  of  intoxications. 

3.  Delirium  of  febrile  maladies. 

4.  Transformation  of  neuroses. 

5.  Transitory  psychoses. 

6.  Pathological  passion. 

7.  Transitory  intellectual  troubles  at  child-birth. 

Alas !  parturiunt  mentes,  nothing  having  been  brought  forth 
by  his  labors  but  confusion. 

This  classification  and  subdivision  of  the  etiology  of  transitory 
mania  is  too  vague  to  secure  importance  with  the  careful  reader ; 
and  if.it  shows  anything,  it  proves  the  error  of  the  author's  theory 
and  the  incorrectness  of  his  conclusions,  for  a  manifestation  of 


42 

frenzy  or  great  mental  excitement  connected  with  either  of  these 
physical  conditions  can  only  be  rationally  considered  as  symp- 
toms of  some  existing  malady. 

If  these  conditions  collectively  have  any  central  meaning, 
they  refer  to  epilepsy,  not  to  mania  transitoria  as  an  idiopathic 
disease,  and  the  words  of  the  author  himself  cannot  lead  one 
astray  from  this  conclusion,  for  he  states:  "All  these  conditions 
of  transitory  disorder  may  prove  very  difficult  to  estimate,  be- 
cause the  direct  examination  of  the  accused  only  affords  negative 
results." 

Clouston,  on  "Mental  Diseases,"  page  162,  remarks:  "I 
think  cases  of  mania  transitoria  result  from  the  following  causes  : 
Most  of  them  are  epileptiform,  are,  in  fact,  of  the  nature  of  men- 
tal epilepsy.  All  the  symptoms  may  be  seen  in  the  incubation 
of  febrile  and  inflammatory  complaints,  such  as  scarlet  fever, 
typhus  and  typhoid,  local  inflammations,  etc." 

He  speaks  of  visiting  a  person  who  was  very  wakeful,  and  was 
laboring  under  some  peculiar  mental  aberration  that  came  on 
suddenly,  and  says,  since  then,  when  he  has  similar  cases,  he  asks 
himself,  "  Is  it  a  case  of  mania  transitoria?"  and  then  states  he 
has  seen  many  similar  cases  in  asylums,  especially  among  epilep- 
tics. 

Edward  C.  Mann,  in  his  recent  work  on  Psychological  Medi- 
cine, page  122,  says:  "There  are  certain  cases  familiar  to  all 
specialists  in  insanity,  which  suffer  from  impulsive  insanity, 
with  a  homicidal  or  suicidal  monomania.  These  patients, 
without  appreciable  disorder  of  the  intellect,  are  impelled 
by  a  terrible  vis  a  tergo,  a  morbid,  uncontrollable  impulse 
to  desperate  acts  of  suicide  or  homicide."  He  also  speaks 
of  a  patient  under  his  care  "who  would  voluntarily  enter  an  asy- 
lum and  remain  there  until  the  morbid  impulse  had  passed  away." 

While  it  should  be  remembered  that  an  isolated  case  is  not 


43 

sufficient  evidence  to  prove  an  important  fact,  the  case  cited 
shows  that  the  proper  exercise  of  the  will  was  sufficient  to  con- 
trol what  the  author  says  is  an  uncontrollable  impulse,  for  the 
patient  went  away  of  his  own  accord  and  escaped  the  reality  of 
his  dreadful  forebodings. 

Again,  on  page  126,  he  says,  as  a  climax  to  the  discussion  of 
inebriety:  ' '  In  these  cases  also  the  mental  disorder  is  of  a  sudden 
and  transitory  character,  not  preceded  by  any  symptoms  calcu- 
lated to  excite  suspicion  of  insanity."  "  It  is  a  transitory  mania, 
or  sudden  paroxysm,  without  antecedent  manifestation,"  the 
duration  of  the  morbid  state  being  short,  and  the  cessation  sud- 
den. Such  attacks  are  transient  in  proportion  to  their  violence, 
and  transition  occurs  on  the  completion  of  the  act  of  violence." 
"  Clearly  allied  to  this  state  of  which  I  have  been  speaking  is  that 
peculiar  psychological  state,  the  trance  state,  which  also  occurs 
in  inebriety." 

Trance  is  an  exceedingly  rare  condition — so  rare,  indeed,  that 
ten  thousand  physicians  may  enjoy  a  large  practice  for  many 
years,  and  not  one  of  them  ever  witness  a  typical  case. 

Alexander  Bain,  in  his  work  upon  the  "  Intellect"  has  many 
valuable  thoughts  connected  with  this  subject,  which  are  in  ac- 
cordance with  the  views  I  have  expressed. 

When  carefully  considered,  this  will  be  found  only  to  relate  to 
some  manifestation  or  symptom  of  a  disease  known  to  exist,  and 
has  no  bearing  upon  the  question  of  transitory  mania  as  an  inde- 
pendent or  idiopathic  disease.  Transitory  mania  as  the  result  of 
inebriety  has  nothing  in  common  with  trance ;  trance  being  un- 
questionably an  idiopathic  condition  in  which  the  patient  re- 
mains as  if  Leothe  had  breathed  over  the  entire  organism  a  feel- 
ing of  repose,  and  left  the  mind  oblivious  to  its  own  conscious- 
ness to  revel  in  dreams  and  ecstacies.  Here  the  author  is  clearly 
in  error,  for  when  he  speaks  of  trance  being  closely  allied  to 


44 

transitory  mania  in  connection  with  inebriety,  he  incorrectly 
classes  trance  with  one  of  the  many  phases  of  epilepsy. 

Clouston,  in  his  work  on  Mental  Diseases,  discusses  the  sub- 
ject of"  impulse  "  in  a  very  fair  tone  of  argument,  and  favors  the 
theory  that  it  is  "  irresistible,"  but  says  nothing  of  "  transitory 
mania,"  and  leaves  the  correctness  of  his  syllogistic  reasoning  to 
the  same  criticism  of  analysis  I  have  given  to  Mann  ;  for  the  lat- 
ter has  not  proven  that  transitory  mania  is  an  idiopathic  disease, 
and  the  former  has  not  shown  that  "  impulse  "  is  uncontrollable. 

The  theory  is  easy  to  accept,  but  in  itself  proves  nothing. 
The  refractory  horse  is  impulsive,  but  by  careful  training  be- 
comes submissive ;  by  kind  treatment  the  wild  animal  obeys  the 
voice  of  its  keeper.  All  impulses  are  the  result  of  cerebral  ex- 
citement, which  by  the  control  of  psychological  forces  may  be 
overcome  in  man  as  in  the  animal,  and  the  person  who  does  not 
attempt  to  control  himself  commits  a  great  moral  wrong,  and  the 
"  sin  of  omission  "  rests  upon  him. 

"'Tis  education  forms  the  common  mind,"  and  even  where 
impulse  is  an  "inheritance,"  the  force  of  moral  training  and  in- 
dividual discipline  can  and  should  hold  it  in  abeyance  as  far  as 
it  relates  to  criminal  action.  The  mother's  love  controls  her  sul- 
len and  sulky  child  until  his  eye  is  full  of  laughter  and  his  cheek 
dimpled  with  smiles.  Psychopathy  controls  the  turbulent  forces 
of  his  inhibitory  nature,  and  he  is  subdued.  Man  is  but  a  child 
of  "larger  growth." 

In  this  connection  we  may  ask  what  are  the  bearings  of  the 
developmental  theory,  and  the  theory  of  evolution,  upon  the 
ethics,  morals,  health,  and  law  of  the  present  age  ?  A  man  is 
either  amenable  to  himself  or  to  some  established  law,  with  pre- 
cepts his  guide,  but  law  his  rule,  and  if  healthful  laws  are  not 
administered,  crime  is  either  evolved  or  developed  for  evolution, 
and  the  highest  interests  of  society  are  sacrificed  to  caprice  and 


45 

misguided  judgment  as  an  unavoidable  sequence.  It  is  only 
through  the  reasoning  by  induction,  inference  and  comparison 
with  concrete  things  and  demonstrative  principles,  we  are  in  any- 
wise able  to  judge  of  the  subtle,  controlling  forces  of  mentality, 
as  witnessed  in  the  agency  and  effect  of  electricity,  produced  by 
induction  or  chemical  reaction,  electrolysis,  Farradism,  magnet- 
ism, etc.  By  the  force  of  constructive  genius  applied  to  mechan- 
ical arts,  we  are  able  by  a  simple  touch  to  illuminate  cities  or 
sound  the  alarm  of  approaching  danger.  But  as  this  paper  is  not 
intended  to  enter  into  an  exhaustive  discussion  of  this  subject, 
connected  with  mind,  I  will  leave  this  train  of  reasoning  to  be 
matured  by  others. 

Mann  (page  43)  says  :  "  In  epilepsy  the  most  internal  part  of 
the  ascending  parietal  convolution  of  the  brain  has  been  found  to 
be  atrophied  and  iriolurated  to  cartilaginous  consistence  as  far  as 
its  embrochure  in  the  fissure  of  Sylvius."  If  we  state  as  a  path- 
ological fact  that  it  is  a  disease  without  a  pathology,  we  shall 
fail  to  keep  in  the  path  of  scientific  truth  and  medical  learning ; 
and  the  more  we  investigate  this  question,,  the  more  certain  will 
become  our  conviction  that  the  plea  of  transitory  mania  is  a 
mere  subterfuge  to  enable  the  criminal  to  escape  legal  responsi- 
bility. 

"  Epileptic  vertigo,  which  a  person  may  have  had  for  years 
without  suspicion  of  its  true  nature,  on  the  part  of  himself  or  his 
friends,  is  very  fruitful  of  mental  disturbances.  The  irritation, 
we  may  call  it,  may  at  any  time  seize  the  higher  centres  of  the 
brain,  instead  of  the  lower,  producing  delirium  as  transient  as 
the  vertigo.  In  this  transitory  mania — for  it  is  such — an  act 
of  violence  may  be  done  for  which  the  patient  is  utterly  irre- 
sponsible."— Fisher,  page  27. 

This  author  keeps  in  the  same  trodden  path  of  all  other  writ- 
ers upon  this  subject,  who  never  fail  to  associate  transitory 


46 

mania  with  epilepsy,  where  it  must  for  ever  rest  as  a  manifesta- 
tion of  disease  rather  than  a  disease  entitled  to  independent 
nosonomy.  Motive  and  volition  cannot  be  separated  in  any  con- 
scious act  performed,  for  there  can  be  no  motive  without  the 
exercise  of  the  will ;  and  if  it  can  be  ascertained  that  a  motive 
existed  for  the  commission  of  a  crime  prior  to  its  committal,  then 
the  act  must  carry  with  it  the  responsibility  of  the  actor. 

All  the  leading  authorities  upon  medical  jurisprudence  and 
mental  diseases,  as  Maudsley,  Ray,  Esquirol,  Hamilton,  Spitzka, 
Bucknell,  Tuke,  Beck,  Taylor,  Browne,  Mann,  and  Luys  upon 
the  "  Functions  of  the  Brain,"  agree  upon  the  legal  proposition 
that  any  party  competent  to  distinguish  right  from  wrong 
stands  in  the  presence  of  the  law  as  sane,  and  is  responsible  for 
his  acts. 

Luys  (page  421)  says  :  "The  corticle  periphery  surrounding 
the  optic  thalami  becomes  intellectualized  in  some  way  to  serve 
as  exciting  material  for  the  activity  of  the  cells  of  the  corticle 
substance.  These  are  the  open  gates  by  which  all  stimuli  from 
without  destined  to  serve  as  pabulum  vitce  for  these  same  corticle 
cells  pass,  and  the  only  means  of  communication  by  which  the 
regions  of  psychical  activity  come  into  contact  with  the  external 
world." 

From  this  view  of  the  author,  there  appears  to  be  no  doubt  of 
a  cerebral  localization  of  psychic  and  intellectual  activity,  and 
"  that  the  sensory  organs  have  a  receptive  organ  in  some  way 
adapted  to  it  in  the  central  regions." 

I  have  stated  I  had  no  objection  to  the  theory  of  transitory 
mania  as  a  symptom  of  some  existing  form  of  insanity,  or  as  a 
manifestation  of  epilepsy;  but  it  would  be  subject  to  less  objec- 
tion to  consider  this  erratic  condition  of  mind  a  nomadic  spasm 
of  localized  forces  of  the  brain  ;  and  if  it  cannot  be  shown  that 
some  lesion  of  the  brain  existed  prior  to  the  outburst  of  criminal 


47 

excitement,  then  the  party  must  be  held  responsible  for  any  act 
of  violence  he  may  have  committed;  for  the  act  would  be  volun- 
tary, and  all  voluntary  acts  can  be  resisted. 

When  this  view  of  the  question  of  transitory  mania  shall  be- 
come established  law,  farcical  court  dramas,  where  the  insane  act 
is  played,  will  no  longer  be  brought  before  the  public,  with  all 
the  mockery  and  satire  upon  justice  and  rhapsody  of  polemic 
pleading  in  such  cases. 

Public  morals  and  common  decency  demand  the  restitution  of 
common  sense  of  parties  interested  in  court  proceedings  in  all 
insane  criminal  actions,  that  juries  maybe  enlightened,  and  not 
confused  by  too  much  technical  law  and  uncertain  testi- 
mony. 

If  a  person  commits  murder  while  intoxicated,  the  law  does 
not  hold  him  guiltless,  because  he  voluntarily  placed  himself  in 
that  condition  which  rendered  him  unconscious  of  the  act  he  .was 
committing.  So  if  one  commits  murder  while  laboring  under 
any  great  impulsive  excitement,  he-  becomes  and  should  be  held 
by  the  law  as  responsible ;  for  all  such  persons  can  control  their 
feelings,  and  would  do  so  if  there  was  a  certainty  of  punishment 
before  them  from  which  they  could  not  escape.  And  here  is 
where  we  see  the  psychopathic  influence  as  a  restraining  force 
in  the  prevention  of  crime;  for  any  specific  law  placed  upon  the 
statutes  affecting  crime,  which  makes  its  punishment  sure,  would 
become  a  psychopathic  force  to  restrain  criminal  action,  and 
more  attention  should  be  given  to  this  subject  in  connection  with 
the  study  of  forensic  medicine. 

Gen.  Grant,  in  a  conversation  with  Prince  Von  Otto  Bismarck, 
alluding  to  the  attempted  assassination  of  King  William,  said : 
"  Although  at  home  there  is  a  strong  sentiment  against  the  death 
penalty  in  cases  of  spasmodic  insanity,  and  it  is  a  sentiment  which 
one  naturally  respects,  I  am  not  sure  but  it  should  be  made  more 


48 

severe,  rather  than  less  severe.  Something  is  due  to  the  offend- 
ed as  well  as  the  offender."  "That,"  replied  the  Prince,  "  is 
entirely  my  view.  My  convictions  are  so  strong  that  I  resigned 
the  government  of  Alsace  because  I  was  required  to  commute 
sentences  of  a  capital  nature. "  Let  there  be  a  few  prompt  ex- 
amples of  laws  faithfully  executed,  and  the  psychopathic  effect 
will  be  so  great  that  homicidal  lawlessness  of  cranks  will  soon 
cease. 

As  objects  multiply  upon  which  we  reason  as  we  advance  in 
intellectual  development,  pari  passu,  so  a  series  of  new  forces 
spring  up,  which  become  factors  in  determining  processes  of 
judgment ;  hence  we  find  equally  well-educated  men  to  differ  in 
their  opinions  upon  questions  involved  in  controversies,  and 
what  seems  material  and  pertinent  to  one  is  objective  to  another 
in  its  logical  sequence  and  application. 

DEFINITIONS    OF    INSANITY. 

The  legal  definition  of  insanity  is,  that  it  is  "a  condition  of 
mind  which  renders  any  party  incapable  of  judging  between 
right  and  wrong  in  any  particular  act  at  the  time  it  is  committed." 
A  philosophical  definition  declares,  "  Insanity  is  a  mental  state 
in  which  acts  of  conception,  judgment,  or  reasoning,  persistently 
express  themselves  as  different  from  the  states  of  feeling  and 
modes  of  thought  usual  to  the  individual  in  health  "  (Combe). 

Such  conditions  as  these  render  the  patient  legally  an  irres- 
ponsible being,  and  unfit  him  eventually  for  the  performance  of 
the  social  and  political  duties  of  life,  for  behind  the  act  remain 
evidences  of  disordered  intellect.  This  conclusion  is  in  accord- 
ance with  the  expressed  views  of  Esquirol,  Tuke,  Winslow  and 
Bucknill. 

A  pathological  definition  of  insanity  is,  an  aberration  and 
erratic  condition  of  mind,  dependent  upon  a  morbid  state  of  the 
cerebral  nerve  centres  which  control  mental  activities ;  and  it 


x  49 

varies  in  form  as  the  location  of  nerve  centres  varies  that  are 
affected,  and  the  changes  produced  in  mental  manifestation  by 
pressure,  over-stimulation,  or  lack  of  nourishment  of  the  brain, 
are  often  analogous  to  the  different  forms  of  paralysis  and  aphasia, 
according  to  the  localized  disturbances.  Under  such  a  condition 
molecular  forces  are  interrupted,  and  mental  activity,  as  the  in- 
tellectual factor  is  left  struggling  .through  abnormal  media  to 
give  expression  ol  the  disturbance  to  the  outward  senses. 

["The  phenomena  of  moral  responsibility,  considered  as  a 
purely  physiological  synthesis  of  all  nervous  activities,  consists 
in  a  series  of  regular  processes,  executed  by  the  organism  at  its 
own  expense,  and  resulting  from  the  harmonic  consensus  of  all 
its  parts.  Moral  sensibility  finds  also  in  the  intervention  of  in- 
tellectual activity  a  new  power  which  excites  it,  makes  it  active, 
and  maintains  it  in  a  perpetual  state  of  erethism."] — Luys,  page 
loy. 

While  this  parenthesis  refers  to  the  social  conditions  of  life,  the 
truths  it  contains  stand  at  the  gateway  that  leads  up  to  the  fun- 
damental truths  of  the  conditions  which  impose  legal  responsi- 
bility. This  also  ac'cords  with  the  modern  researches  of  those 
who  have  given  much  careful  attention  to  neurology  and  the 
functions  of  the  brain,  and  is  the  echo  of  the  voice  of  science, 
reverberating  through  all  the  avenues  of  thought  and  the  intri- 
cacies of  life,  arousing  the  force  of  mental  activity,  the  vividu  vis 
animi,  which  awaken  the  consciousness  of  the  errors  of  judg- 
ment manifested  in  crime. 

Ray,  in  his  "Jurisprudence  of  Insanity,"  states  that  "the  pro- 
pensities and  sentiments  are  also  integral  portions  of  our  mental 
constitution;  and  enlightened  physiologists  cannot  doubt  that 
their  manifestations  are  dependent  upon  the  cerebral  organiza- 
tion." 

As  far  back  as  the  days  of  Paracelsus  and  Democritus,  Hypoc- 


50 

rates  expresses  his  views  of  cerebral  physiology  and  of  the  path- 
ology of  insanity  as  follows,  viz  :  "  Men  ought  to  know  that  from 
nothing  else  but  thence  [referring  to  -the  brain]  come  joys,  de- 
spondency and  lamentations." 

Says  Aitken :  "To  consider  the  subjective  phenomena  which 
collectively,  in  their  various  manifestations,  constitute  mind,  an 
immaterial  essence,  as  liable  to  disease  apart  from  all  derange- 
ment of  the  material  organ,  the  instrument  with  which  it  is  so 
closely  and  indissolubly  united,  is  to  believe  in  a  most  incongru- 
ous, imphilosophical,  unphysiological  doctrine.  The  more  con- 
sistent theory  is  that  which  is  known  as  the  cerebral  theory,  now- 
entertained  by  most  of  the  eminent  physicians  who  have  made 
insanity  a  special  study." 

Dr.  Boyd  records  the  singular  fact  that  almost  invariably  the 
weight  of  the  left  cerebral  hemisphere  exceeds  that  of  the  right 
by  at  least  an  eighth  of  an  ounce. 

The  weight  of  the  brain  under  different  forms  of  insanity  has 
been  found  as  follows,  viz  :  In  mania  the  brain  weighs  54  oz. 
11^2  drams;  in  monomania,  51  oz.  u^  drams;  in  dementia, 
50  oz.  5  I  drams;  in  general  paralysis,  49  oz.  12  S9  drams.  This 
tabular  statement  shows  most  conclusively  that  the  true  path- 
ology of  insanity  is  found  in  the  encephalon.  The  specific  gravity 
also  varies  in  the  white  and  gray  matter. 

Aitken  alludes  to  irresistible  impulse,  but  thinks  unresisted  a 
better  term. 

I  introduce  these  facts  to  show  the  difference  between  insanity 
as  a  fact  and  the  theory  of  insanity  in  mania  transitoria,  the  lat- 
ter having  no  pathology ;  and  while  the  logic  in  any  particular 
case  may  be  correct,  the  premises,  a  priori,  being  false  upon 
which  to  base  a  plea,  the  conclusions  must  necessarily  be  wrong 
and  verdicts  will  be  rendered  in  favor  of  the  criminal. 

Clouston   (page   232)  says :  ' '  Professor  Benedick,  of  Vienna, 


51 

showed  at  the  International  Medical  Congress  of  1881,  in  Lon- 
don, a  number  of  brains  of  habitual  criminals,  who,  he  affirmed, 
had  their  convolutions  arranged  in  a  certain  simple  form  peculiar 
to  the  criminal  classes,  so  that  on  seeing  such  a  brain  he  could 
tell  the  ethical  tendencies  of  the  person  to  whom  it  belonged,  just 
as  one  can  tell  a  dog  to  be  a  bull-dog  by  his  jaws." 

When  one  is  suffering  from  dementia,  the  listless,  incoherent 
condition  is  interrupted  by  a  sudden  loud  tone  of  voice,  that 
causes  a  vibration  of  certain  cerebral  nerve  centres,  which  is 
exhausted  in  a  vocal  response,  while  the  party  is  wholly  uncon- 
scious of  its  meaning  or  of  any  of  the  surroundings. 

Bucknill  and  Tuke,  in  their  work  upon  "  Physiological  Medi- 
cine," page  443,  referring  to  the  pathology  of  insanity  to  cerebral 
disturbance,  state  the  following  facts  :  "Greeding,  in  216  cases, 
found  the  skull  unusually  thick  in  167,  the  dura  mater  adherent 
to  the  cranium  in  107  cases,  the/>/#  mater  thickened  and  opaque 
in  86  out  of  100  cases  of  mania,  and  beset  with  hydatids  and 
spongy  bodies  in  92  out  of  100  cases.  The  choroicl  plexus  was 
found  healthy  in  these  respects  in  only  16  cases  out  of  219. 
Merkel  noticed  the  increased  density  of  the  cerebral  substance" 
in  insanity. 

Scemmering  and  Arnold  confirm  these  observations,  and  Pas- 
cal declares  that  all  mental  diseases  are  the  effect  of  "morbid 
alterations  in  the  brain  and  spinal  cord."  I  will  also  call  atten- 
tion to  the  views  of  Virchow,"as  expressed  in  his  "  Cellular  Path- 
ology," in  support  of  the  same  conditions.  While  his  views  are 
not  given  in  connection  with  any  discussion  of  this  subject 
directly,  they  have  an  important  bearing  upon  the  theory  that  all 
insanity  is  dependent  upon  cerebral  changes,  which  may  be  slow 
and  progressive  in  nature,  as  when  melanoid  tumors  or  gliomata 
press  upon  the  corpus  striatum,  "that  have  their  origin  in  the 
neuroglia  of  the  interstitial  connective  tissue,"  and  many  other 
forms  of  change. 


52 

It  is  not  logical  to  say  because  the  song  of  the  bird  is  not 
found  in  its  throat,  ergo,  the  anatomical  structure  of  the  throat 
has  nothing  to  do  with  the  musical  notes  ;  nor  would  it  be  rea- 
sonable to  say  because  specific  lesions  were  not  found,  ergo,  the 
anatomical  changes  of  the  eucephalon  had  nothing  to  do  with 
mental  diseases. 

Most  of  the  late  writers  agree  to  this  proposition,  and  daily 
experience  proves  its  correctness:  "  We  must  be  careful  not  to 
underrate  their  importance  on  account  of  the  occasional  absence 
of  anatomical  changes  after  death,  and  to  conclude  that  for  this 
reason  such  anatomical  lesions,  when  present,  may  not  be  the 
cause  of  the  mental  disorder." — Griesinger,  page  297. 

While  man  does  not  possess  a  prescient  mind  that  would  en- 
able him  to  unmast  the  speculative  thought  which  underlies  and 
controls  much  of  human  action,  a  knowledge  of  the  force  of 
mental  activity  must.be  gained  through  a  comparison  of  the 
negative  with  the  active  life  manifested  in  physical  efforts.  The 
General  upon  the  battle-field  gives  the  command,  and  the  force 
of  the  law  of  obedience  brings  contending  armies  together  in 
deadly  strife,  and  human  life  is  sacrificed.'  This  is  a  fair  illustra- 
tion of  the  force  of  the  law  of  psychopathy,  and  will  enable  us  to 
judge  more  fairly  of  the  contingent  results  of  daily  action,  and 
show  how  the  positive  execution  of  law  will  tend  to  lessen 
criminal  action. 

The  clinical  importance  of  the  subject. of  psychology  and  biol- 
ogy, as  questions  of  science,  seems  to  have  been  overlooked  by 
our  teachers  of  medicine,  and  as  yet  these  branches  have  not 
been  assigned  a  place  in  the  college  curriculum ;  and  whatever 
of  public  attention  may  have  been  directed  to  this  department 
of  learning,  none  but  the  flippant  writers  upon  the  stage  of  ex- 
periments have  undertaken  the  explanation  of  the  curious  effects 
mind  of  upon  mind,  until  quite  recently,  notwithstanding  Baron 


53 

Reichenbach's    experiments   in   odic   forces   and   biology  nearly 
thirty  .years  ago. 

"  I  know 

That  \\  here  the  spade  is  deepest  driven. 
The  best  fruits  grow/' 

and  make  the  following-  quotations  from   the  work  of  Griesinger 
upon  "  Mental  Pathology:" 

"  Emotion,  when  transitory,  and  occurring  in  previously  healthy 
organisms,  is  speedily  calmed ;  when,  however,  bodily  disease  is 
already  present,  and  when  the  causes  are  long-continued,  there 
generally  arise  many  complicated  disorders  of  the  organic  mech- 
anism, which  the  simple  cessation  of  the  emotion  cannot  as 
quickly  terminate." — Page  40. 

"  Very  much  depends  upon  the  duration   and  intensity  of  the 
phenomena,  whether  we  consider  the  mental  state  as  morbid. "- 
Page  44. 

"  We  frequently  see  in  subjects  who,  up  to  that  moment,  have 
been  in  the  actual  or  at  least  apparent  enjoyment  of  perfect  health, 
jusjt  as  in  some  of  those  cases  in  which  there  is  developed  a  sui- 
cidal tendency,  attacks  of  most  violent  anxiety  with  obscuring  of 
consciousness  suddenly  show  themselves,  accompanied  with 
frightful  hallucinations,  during  which  the  patient,  in  the  blind- 
ness of  his  fury,  seeks  to  slay  all  who  come  in  his  way.  These 
cases,  which,  judged  by  their  symptoms,  appertain  more,  it  is 
true,  to  mania,  but  which  in  their  psychological  relations  repre- 
sent violent  fits  of  melancholic  anxiety,  and  especially  morbid 
negative  emotions,  possess,  in  their  want  of  any  moral  cause,  a 
great  analogy  to  those  sudden  fits  of  profound  anxiety  and  se- 
vere mental  suffering  which  have  sometimes  been  witnessed  as 
precursors  of  epileptic  attacks." — Page  184.. 

I'ncler  this  head  come  "  those  cases  in  which  those  homicidal 
impulses  suddenly,  and  without  external  motive,  arise  in  persons 


54 

who  have  been  hitherto  of  a  lively,  joyous,  and   loving  disposi- 
tion, and  incessantly  intrude  themselves  upon  their  thoughts. "- 
Page  185. 

Here  the  author  refers  to  several  notable  examples  of  homi- 
cidal impulse  :  "  A  distinguished  chemist,  tormented  with  a  homi- 
cidal impulse,  would  often  prostrate  himself  before  the  altar  and 
implore  the  Deity  to  deliver  him  from  the  atrocious  propensity," 
etc.  Also  refers  to  Catherine  Olhaver,  to  a  nurse,  and  the  wife 
of  a  shoemaker,  who  were  "seized  with  an  almost  irresistible 
impulse." — Page  187. 

He  also  speaks  of  the  "habitual  perversion  of  the  feelings 
with  impulsive  fits  of  anger,  without  any  derangement  of  the  in- 
tellect," and  cites  the  case  of  "  an  only  son,  brought  up  under 
the  eyes  of  a  weak  and  indulgent  mother,  who  early  acquired 
the  habit  of  yielding  1o  all  his  caprices  and  to  all  the  impulses 
of  a  restless  and  ardent  temperament"  (page  190),  and  on  page 
208,  example  xxxv.,  refers  to  "paroxysms  of  fury,"  and  as  an 
illustration  relates  the  story  of  the  Swabian  peasant,  with  which 
every  student  of  psychological  medicine  is  familiar  ;  but  in  none 
of  these  cases  has  he  shown  that  the  impulse  is  irresistible. 

Upon  such  cases  as  these  is  based  the  testimony  in  favor  of 
the  theory  of  ephemeral  "transitory  mania,"  with  which  our 
court  calendars  are  filled  ;  and  these  cases  even  do  not  prove 
either  the  conscious  or  unconscious  irresistible  nature  of  the 
malady;  nor  does  this  classical  writer  claim  or  attempt  to  prove 
that  transitory  mania  exists  as  an  idiopathic  disease,  and  com- 
mon intelligence  forbids  such  labor,  as  an  effort  against  justice 
and  moral  rectitude. 

"  The  fundamental  disorder  in  mania,  the  irritation  upon  the 
motory  side  of  the  soul-life,  exhibits  itself,  first  of  all,  in  this 
sphere,  as  a  high  degree  of  mental  excitement,  with  restlessness, 
impetuous-<ind  violent  desires  and  actions."  "The  pleasure  in 


55 

loud  speaking,  in  shedding  blood,  etc.,  may  show  itself  in  those 
violent  and  boisterous  ways,  and  these  results,  fixed  or  transitory 
conditions  which,  according  to  the  predominance  of  this  or  that 
desire,  are  known  under  the  name  of  kleptomania,  homicidal 
mania,  etc." — Page  197. 

"  Generally,  from  the  commencement  of  insanity,  or  at  least 
very  soon,  the  quantitative  increase  and  exaltation  of  thought  are 
so  great  that  there  results  a  restless  and  constant  succession  of 
isolated  ideas  which  have  no  intimate  relations  with  each  other, 
and  constantly  change  their  combinations,  are  very  transitory,  or 
of  a  very  fragmentary  nature." — Page  199. 

"  Whether,  and  to  what  extent,  certain  directions  of  the  will 
and  impulses  in  the  insane',  particularly  such  as  lead  to  criminal 
acts,  are  irresistible,  is  a  question  which  can  scarcely  be  answered 
with  certainty." — Page  55. 

"  As  to  the  invasion  and  course  of  mania,  it  is  observed  some- 
times as  a  pure  and  independent  form  of  mental  disease,  as  a 
stage  of  development  in  the  successive  series  of  mental  disor- 
ders ;  sometimes  transient  attacks  of  mania,  or  more  correctly  of 
fury,  occur  in  individuals  who  are  already  subjects  of  profound 
mental  disease."  "  In  epileptics,  also,  it  is  not  uncommon  to  ob- 
serve attacks  of  mania  which  are  often  characterized  by  a  high 
degree  of  blind  jury  and  ferocity.  Sometimes  they  immediately 
follow  the  epileptic  attacks." — Page  203. 

The  same  field  of  research  has  been  traversed  by  this  learned 
and  classical  writer  that  has  so  repeatedly  been  investigated  by 
others,  without  any  apparent  effort  to  prove  how  such  a  condition 
can  occur  possibly  under  the  laws  of  psychopathy  or  psychosis, 
as  understood  at  the  present  time;  and  until  some  more  positive 
evidence  of  its  existence  shall  be  presented,  the  duty  I  owe  to 
society  will  make  it  my  aim  and  urge  me  to  oppose  the  theory 
of  transitory  mania  as  an  ogre  too  mythical  to  be  brought  be- 


fore  courts  and  juries.  The  baneful  effects  of  this  theory  upon 
public  morals  are  matters  of  record  and  familiar  to  the  judiciary 
of  our  country. 

In  discussing-  this  subject  I  have  endeavored  to  avoid  sacrific- 
ing facts  to  either  ethics  or  rhetoric,  holding  that  the  cognate 
sciences  are  the  factors  to  be  relied  upon  to  explain  by  compari- 
son and  illustrate  the  phenomena  of  cause  and  effect ;  and  have 
endeavored  to  show  that  while  the  remote  causes  of  insanity 
multiply  with  daily  experience,  pathologists  have  established  the 
tact  that  the  disease  itself  is  dependent  upon  cerebral  lesions  and 
disturbances  of  nerve  centres  of  the  encephalon,  which  may  be 
either  primary  or  dependent  upon  reflex  action,,  as  in  hysteria, 
dyspepsia,  disease  of  the  heart,  spine,  liver,  and  kidneys.  "The 
anatomical  changes  which  indicate  insanity — that  is,  which  pro- 
duce psychical  anomalies  during  life — are  naturally  sought  for 
within  the  cranium,  in  the  brain  and  its  membranes."  —  Grie- 
singer,  page  290. 

Thus,  with  the  preponderance  of  evidence  in  our  favor,  we  are 
forced  to  conclude  that  it  is  impossible  for  transitory  mania  to 
hold  a  place  in  medicine,  per  se,  and  that  the  theory  is  surround- 
ed by  more  empiricism  of  law  and  medicine  than  any  other  hum- 
bug of  modern  times. 

In  conclusion,  whatever  may  be  thought  of  our  method  of  life 
and  our  efforts  in  the  various  walks  of  a  chosen  profession,  may 
we  never  forget  to  cherish  a  love  for  justice,  reverence  for  law, 
respect  for  the  rights  of  others  and  sympathy  for  the  unfortunate 
in  mind;  and  when  our  labors  shall  cease,  may  we  have  a  con- 
sciousness of  having  performed  our  duties  faithfully  and  well, 
without  fear  or  prejudice  towards  any. 

"  Whatever  creed  be  taught  or  land  be  trod, 
Man's  conscience  is  the  oracle  of  God." 


6Deo'5 


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RSITY  OF  CALIFORNIA  LIBRARY 


